□Four-bed Room四人间
申请居住时间Accommodation Period
预计入住时间
Expected Move-IN Date (yy/mm/dd)
预计搬出时间
Expected Move-OUT Date (yy/mm/dd)
申请人签字：Applicant’s Signature
Y年M月D日
2、The student should pay 600rmb as deposit for each person, please get prepared.
护照号码
Passport No.
国籍/地区Nationality/
Region
宗教Religion
留学类别
Application
Categories
□自费留学生Self-funded students
□中国政府奖学金留学生ChineseGovernment Scholarship Student
□其他类型奖学金留学生OtherScholarship Student
□医学预科生Pre-med□语言生Language Student
□本科生Bachelor□硕士生Master□博士生Doctor
□校际交流学生Interschool Exchange Student
如是，学校为If so, which University/College:___________
是否吸烟
Smoking
电子邮箱E-mail
电话Tel.
选o.1一号楼□Building No.2二号楼
□Building No.3三号楼□Building No.4四号楼
□Single room with private bathroom单人间（独立浴室）
□Double Room双人间
留学生住宿申请表
ACCOMODATION APPLICATION FORM
学号StudentNumber: ________________
基本信息
Basic Information
姓名
Name
中文（如有）
Chinese Name(if have)
英文English Name
性别
Gender
出生日期Birth date
审批情况
Examination
And Approval
注明是否同意，房间号码等。
Y年M月D日
注：
1、请如实完整填写本表。
2、入住需缴纳押金600元人民币，请提前做好准备。
Notes:
1、Please complete this form with clear writing and sincerity.