外国人来华工作许可申请表

（来华工作90日以上）

APPLICATION FORM FOR FOREIGNER'S WORK PERMIT

（WORKING PERIOD OF MORE THAN 90 DAYS）

CURRENT WORK PERMIT NUMBER SURNAME (As in Passport)

外国人工作许可证号姓（如护照所示） 不需填写，系统自动生成 名（如护照所示）FIRST AND MIDDLE NAMES (As in Passport) 中文姓名 CHINESE NAME ISSUANCE DATE CHINESE PROFICIENCY 别名或曾用名（英文）OTHER NAME USED 性别 GENDER 出生日期DATE OF BIRTH(yyyy-mm-dd) 护照类型 PASSPORT TYPE 护照有效期至EXPIRATION DATE(yyyy-mm-dd) 照片PHOTO HIGHEST ACADEMIC DEGREE 国籍NATIONALITY 婚姻状况MARITAL STATUS 护照号码 PASSPORT NUMBER 最高学位（学历）护照签发日期 汉语水平 是否持有境外职业资格证书HAVE YOU EVER OBTAINED ANY PROFESSIONAL QUALIFICATION CERTIFICATE ABROAD? 职业资格证书名称和编号NAME AND NUMBER OF PROFESSIONAL QUALIFICATION CERTIFICATES 工作年限 LENGTH OF WORKING TIME INTENTED JOB TITLE IN CHINA 申请人电子邮箱 E-MAIL ADDRESS 列出所有曾授予你护照的国家LIST ALL COUNTRIES THAT EVER ISSUED YOU A PASSPORT 工作岗位（职业）OCCUPATION 所属行业INDUSTRY CATEGORY RECOGNIZED PROFESSIONAL ACHIEVEMENT 聘用合同/任职证明在华工作起始时间INTENTED WORKING TIME IN CHINA EMPLOYMENT METHOD 申请在中国工作职务 聘用方式 薪酬 SALARY(monthly) 每年在华工作时间（月)WORKING TIME IN CHINA PER YEAR(months) 行业主管部门名称 公认职业成就申请在华工作时间INTENTED LENGTH OF WORKING TIME IN CHINA 是否毕业于世界知名大学 ARE YOU GRADUATED FROM WORLD RENOWNED UNIVERSITIES 是否需要行业主管部门批准DO YOU NEED APPROVAL FROM RELATED CHINESE INDUSTRY AUTHORITY? NAME OF INDUSTRY AUTHORITY 行业主管部门批准证书文号 APPROVAL DOCUMENT NUMBER 是否持有中国职业资格证书（准入类）HAVE YOU EVER OBTAINED ANY CHINESE PROFESSIONAL QUALIFICATION CERTIFICATE (For Vocational Accession )? 职业资格证书（准入类）名称 NAME OF CHINESE PROFESSIONAL QUALIFICATION CERTIFICATES(For Vocational Accessio) NUMBER OF CHINESE PROFESSIONAL QUALIFICATION CERTIFICATES OBTAINED 职业资格证书号码 是否曾在世界500强企业、知名金融机构或律师事务所等任职DO YOU HAVE ANY EXPERIENCE IN WORLD TOP 500 COMPANIES,WELL-KNOWN FINANCIAL INSTITUTIONS OR LAWFIRMS? YOU HAVE EVER HELD IN AFOREMENTIONED ORGANIZATIONS 在上述单位曾担任最高职务HIGHEST POSITION 已连续在华工作年限 CONSECUTIVE WORKING YEARS IN CHINA NAME OF DISPATCHING INSTITUTION ABROAD BUSINESS TELEPHONENUMBER IN CHINA 境外派遣单位名称 派遣单位所在国家 LOCATION OF DISPATCHING INSTITUTION ABROAD 是否有专利等知识产权 POSSESS ANY PATENT OR OTHER INTELLECTUAL PROPERTY RIGHTS 在中国工作电话 DESCRIPTION IN CHINA 在中国工作任务JOB LIST ALL HIGHER EDUCATIONAL INSTITUTIONS YOU HAVE ATTENTED (INCLUDING VOCATIONAL INSTITUTIONS) 列出曾就读的高等教育学校（含职业教育学校，如无高等教育经历，请填写最高学历） 学位 就读时间 专业名称 所在国家 DATES OF NAME LOCATION SPECIALITY ATTENDANCE 列出曾工作的单位(近十年内) ACADEMIC QUALIFICATION LIST ALL EMPLOYERS YOU HAVE WORKED FOR IN LAST TEN YEARS 名称 工作所在国起止时间 工作岗位职务 NAME DATES OCCUPATION JOB TITLE 家LOCATION 随行家属情况 ACCOMPANYING FAMILY MEMBERS 是否有家属随行人数NUMBER DO YOU HAVE ANY OF THE ACCOMPANYING ACCOMPANYINMEMBER? G MEMBERS 出生日期 随行家属姓名 与申请人关系 DATE OF 性别国籍NAME (As in RELATIONSHIP TO BIRTH(yyyy-GENDER NATIONALITY Passport) THE APPLICANT mm-dd) EMERGENCY CONTACT PERSON IN CHINA 工作任务 JOB DESCRIPTION 护照号码 PASSPORT NUMBER 联系电话EMERGENCY CONTACT TELEPHONE NUMBER 电子邮箱在华紧急联系人 E-MAILADDRESS APPLICATION FOR FOREIGNER'S WORK PERMIT 申领外国人工作许可证 入境时间DATE OF ENTRY 持有签证种类 TYPE OF VISA HELD 签证号码VISA NUMBER □是 YES □否 NO □是 YES □否 NO □是 YES □否 NO 您是否由于犯有任何罪行而曾经被逮捕或被判有罪，即使后来得到了赦免或收回等其他类似措施？HAVE YOU EVER BEEN ARRESTED OR CONVICTED FOR ANY OFFENSE OR CRIME, EVEN THOUGH SUBJECT OF A PARDON, AMNESTY OR OTHER SIMILAR LEGAL ACTION? 您是否曾感染过对公共健康有影响的传染病或患过可造成危险的身体疾病或精神病？HAVE YOU EVER BEEN AFFLICTED WITH A COMMUNICABLE DISEASE OF PUBLIC HEALTH SIGNIFICANCE OR A DANGEROUS PHYSICAL OR MENTAL DISORDER? HAVE YOU EVER VIOLATED THE LAW OF CHINA, AND DEPORTED FROM CHINA? 您是否曾违反中国法律，被中国政府递解出境？ 本人郑重承诺，在本国及境外无犯罪记录，来华工作后，将严格遵守中国法律法规，自觉服从聘请单位各项管理制度。本申请表上所做之回答均属事实且详尽，所附材料真实、有效，若所提交的内容被发现不实或不详，本人愿意承担法律责任。对所提交的全部申请信息和附件授权可以调查，包括我的雇佣情况、工作表现、工作能力、教育、个人经历和无犯罪记录。如果我已超过60周岁，确保在中国工作期间有相应的医疗保险。 I SOLEMNLY PROMISE THAT I HAVE NO CRIMINAL RECORD BOTH AT MY HOME COUNTRY AND ABROAD. WHEN I ARRIVE IN CHINA AND START TO WORK, I WILL STRICTLY ABIDE BY THE CHINESE LAWS AND REGULATIONS, AND CONSCIOUSLY OBEY THE MANAGEMENT SYSTEM OF THE EMPLOYING INSTITUTION. I CERTIFY THAT ALL THE ANSWERS TO THIS APPLICATION AND RELEVANT ATTACHMENTS TO IT ARE TRUE AND COMPLETED. IF THE INFORMATION IS FOUND TO BE UNTRUE OR UNCOMPLETED, I AM AWARE THAT I NEED TO UNDERTAKE CORRESPONDING LEGAL RESPONSIBILITIES.I UNDERSTAND THAT ALL OF THE INFORMATION IN THIS APPLICATION AND DOCUMENTS SUBMITTEDWITH THIS APPLICATION MAY BE CHECKED BY RELEVANT PARTIES, INCLUDINGMY EMPLOYMENT, WORK PERFORMANCE,ABILITIES,EDUCATION,PERSONAL EXPERIENCES AND CONVICTION RECORDS.I CONFIRM THAT, IF I AM OVER SIXTY YEARS OLD,I WILL APPLY FOR MEDICAL INSURANCE COVERAGE AS ARE NEEDED DURING MY WORK PERIOD IN CHINA. 申请人签名SIGNATURE OF APPLICANT 日期DATE(yyyy-mm-dd) 用人单位承诺如实向行政机关提交有关材料和反映真实情况，并对申请材料实质内容的真实性负责,承担相关法律责任。 THE EMPLOYER HEREBY DECLARES THAT ALL THE DOCUMENTS AND INFORMATIONS SUBMITTED TO THE AUTHORITY ARE TRUE,AND SHALL BE RESPONSIBLE TO THE AUTHENTICITY OF THE DOCUMENTS AND UNDERTAKE CORRESPONDING LEGAL RESPONSIBILITIES. 用人单位公章 SEAL OF EMPLOYER 日期 DATE(yyyy-mm-dd) 外国人来华工作许可申请表

（来华工作90日以下,含90日）

APPLICATION FOR FOREIGNER’S WORK PERMIT

(WORKING PERIOD OF LESS THAN 90 DAYS, 90 DAYS INCLUDED)外国人工作许可通知编号 不需申请人填写,系统自动生成 PRESENT WORK PERMIT NUMBER 姓（如护照所示）SURNAME (As in Passport) 名（如护照所示）FIRST AND MIDDLE NAMES (As in Passport) 中文姓名 CHINESE NAME性别 GENDER 国籍 NATIONALITY 婚姻状况MARITAL STATUS 护照类型PASSPORT TYPE 护照有效期至EXPIRATION DATE(yyyy-mm-dd) 行业主管部门名称NAME OF INDUSTRY AUTHORITY 申请在华工作时间INTENTED LENGTH OF WORKING TIME IN CHINA 工作日程 WORK SCHEDULE 护照号码 PASSPORT NUMBER 工作单位EMPLOYER 行业主管部门批准证书文号 SERIAL NUMBER OF APPROVAL DOCUMENT 在中国工作联系电话 BUSINESS TELEPHONE NUMBER IN CHINA 别名或曾用名（英文）OTHER NAME USED 性别 GENDER 出生日期DATE OF BIRTH(yyyy-mm-dd) 照片PHOTO 最高学位（学历）HIGHEST ACADEMIC DEGREE 护照签发日期ISSUANCE DATE (yyyy-mm-dd) 是否需要行业主管部门批准DO YOU NEED APPROVAL FROM RELATED CHINESE INDUSTRY AUTHORITY? 申请在中国境内工作地点 INTENTED WORKING PLACE(S) IN CHINA 在中国工作邮箱 EMAIL ADRRESS 本人郑重承诺，在本国及境外无犯罪记录，来华工作后，将严格遵守中国法律法规，自觉服从聘请单位各项管理制度。本申请表上所做之回答均属事实且详尽，所附材料真实、有效，若所提交的内容被发现不实或不详，本人愿意承担法律责任。对所提交的全部申请信息和附件授权可以调查，包括我的雇佣情况、工作表现、工作能力、教育、个人经历和无犯罪记录。如果我已超过60周岁，确保在中国工作期间有相应的医疗保险。 I SOLEMNLY PROMISE THAT I HAVE NO CRIMINAL RECORD BOTH AT MY HOME COUNTRY AND ABROAD. WHEN I ARRIVE IN CHINA AND START TO WORK, I WILL STRICTLY ABIDE BY THE CHINESE LAWS AND REGULATIONS, AND CONSCIOUSLY OBEY THE MANAGEMENT SYSTEM OF THE EMPLOYING INSTITUTION. I CERTIFY THAT ALL THE ANSWERS TO THIS APPLICATION AND RELEVANT ATTACHMENTS TO IT ARE TRUE AND COMPLETED. IF THE INFORMATION IS FOUND TO BE UNTRUE OR UNCOMPLETED, I AM AWARE THAT I NEED TO UNDERTAKE CORRESPONDING LEGAL RESPONSIBILITIES.I UNDERSTAND THAT ALL OF THE INFORMATION IN THIS APPLICATION AND DOCUMENTS SUBMITTED WITH THIS APPLICATION MAY BE CHECKED BY RELEVANT PARTIES, INCLUDINGMY EMPLOYMENT, WORK PERFORMANCE,ABILITIES,EDUCATION,PERSONAL EXPERIENCES AND CONVICTION RECORDS.I CONFIRM THAT, IF I AM OVER SIXTY YEARS OLD,I WILL APPLY FOR MEDICAL INSURANCE COVERAGE AS ARE NEEDED DURING MY WORK PERIOD IN CHINA. 申请人签名SIGNATURE OF APPLICANT 日 期 DATE(yyyy-mm-dd) 用人单位承诺如实向行政机关提交有关材料和反映真实情况，并对申请材料实质内容的真实性负责,承担相关法律责任。 THE EMPLOYER HEREBY DECLARES THAT ALL THE DOCUMENTS AND INFORMATIONS SUBMITTED TO THE AUTHORITY ARE TRUE,AND SHALL BE RESPONSIBLE TO THE AUTHENTICITY OF THE DOCUMENTS AND UNDERTAKE CORRESPONDING LEGAL RESPONSIBILITIES 用人单位公章 日期 DATE(yyyy-mm-dd)

SEAL OF EMPLOYER