1、专业技术职务申请表专业技术职务申请表（青年杰出人才申请正高级专业技术职务评聘专用）Application Form for Position of Professor or Equivalent Position, SYSU Outstanding Young Faculty Use Only编号No.：申请职位Position to Apply应聘学院（系）School/ Department to Apply申请学科Academic Fieldto Apply一、个人资料Personal Information姓名Applicant Name性别Gender出生年月Date of Birt
2、h国籍Nationality最高学历、学位Highest Degree毕业院校Degree Institution毕业时间Graduation Year现聘单位Current Employer现聘职位Current Academic Title任职年月Starting from (M/Y)从事专业Field of Expertise研究方向Research Interests身份证号码ID No.电子邮件Email通讯地址MailingAddress手机Mobile No.2、学习经历（大学及以上，含海外进修经历）Educational Background (Bachelor degree
3、and above, overseas study included)起止年月Date学校名称Schools/Institutions Attended（海外高校请注明所在国家)(Country Should be Stated）学历/学位Degree Obtained专业Major自From至To三、工作经历Employment History起止年月Date工作单位/机构Schools/ Institutions of Employment职务Position Held自From至To四、学术荣誉及社会兼职Academic Honors &Social Services荣誉/社会兼职Tit
4、le of Honors/ Services获得/受聘日期Date Obtained颁授/兼职机构Issued/Employed By五、教学工作（任现职近五年内）（可另附页）Teaching Experience(most recent 5 years; if current position is shorter than 5 years, please list the experiences since the position started; if needed, attach a sheet.)1课程教学情况（学年学期至学年学期）Courses TaughtFrom the (1
5、st/2nd )Semester(Year) to(1st/2nd ) Semester(Year)类别Type开课学年学期Semester and Year教学课程名称Course Title课程属性Course Type(Compulsory/Selective）学分Credit学时Credit Hour授课对象及人数Targeted Student and Number of Enrollment实际担任课堂教学学时数Actual Credit Hour for Classroom Teaching课程系数Course Coefficient工作量Amount of Teaching L
6、oadTeachingFull-time Undergraduates 普通全日制本科生教学总计学时数Total Credit HoursTeaching Graduates研究生教学总计学时数Total Credit Hours2指导学生情况Students Supervised学生类别Student Type时间Period(年月年月）学生数（专业、年级、姓名）Student List (major, year in program, name)折合学时数Equivalent Credit HoursPh.D Candidates指导博士生Master Degree Candidates指
7、导硕士生Supervising Graduation Thesis for Undergraduates指导普通全日制本科生毕业论文其他Others总计学时数Total Credit Hours3审核意见Verification（1）对校本部申请者的审核意见 Verification for Applicants from the Main Campuses承担普通全日制本科教学工作量合计学时，年平均教学工作量学时。其中，课程教学共学时，指导毕业论文工作量学时，本科生教育教学其他工作折合工作量学时。For Full-time Undergraduate Teaching：Total Credi
8、t Hours:Average Annual Credit Hours: Course Teaching Hours: Thesis Supervision Hours: Other Equivalent Credit Hours:院系审核人签字Reviewed by：年月日Y/M/D本科教学主管部门审核意见：Verification by the Department in Charge of Undergraduate Teaching:经核实，普通全日制本科生课程教学工作量学时。For Full-time Undergraduate Teaching：Total Credit Hours
9、:审核人签字Reviewed by：单位（公章）Official Seal：年月日Y/M/D承担研究生教学工作量合计学时，年平均教学工作量学时。其中，研究生课程教学共学时，指导研究生折合学时。For Graduate Teaching：Total Credit Hours: Average Annual Credit Hours:Course Teaching Hours:Thesis Supervision Hours:院系审核人签字Reviewed by：年月日Y/M/D研究生教学主管部门审核意见Verification by the Department in Charge of Gra
10、duate Teaching:：经核实，研究生课程教学工作量学时，指导博士研究生名、硕士研究生名。For Graduate Teaching：Course Teaching Hours:Total number of supervised Ph.D candidates：Total number of supervised Master Degree candidates ： .审核人签字Reviewed by：单位（公章）Official Seal：年月日Y/M/D(2) 对附属医院申请者的审核意见Verification for Applicants from the Affiliated
11、 Hospital经核实，教学工作量分，教学质量评价分，教学总分分。By verification, the score for teaching load is , the score for teaching quality is , the total score is .教学管理部门审核人签字Reviewed by(from the Department in Charge of Teaching)：单位（公章）Official Seal：年月日Y/M(3)本科教学主管部门审核意见Verification by the Department in Charge of Undergrad
12、uate Teaching经核实，在入校工作以来有/无教学工作违纪记录。如有，请写明时间及处理结果：By verification, Dr.(NAME) hasnt any/ has some record(s) of violating teaching discipline since he/she began to work at SYSU; if has, please list the date and results below: 审核人签字Reviewed by：单位（公章）Official Seal：年月日Y/M六、研究工作（近五年内）（可另附页）Research (most
13、recent 5 years; if needed, attach a sheet. )1申请人学术陈述Research Statement（请陈述个人学术发展目标、5年学术计划、当前工作中可望取得突破的课题，以及三者之间的关联性）(State the applicants aims of academic development, plans for the next fiveyears, difficultresearch problems may be solved and the relation among the above three aspects.)2代表性论著Represe
14、ntative Publications序号#按全部作者排序（注明学生、通讯作者、共同第一作者、共同通讯作者）、论文题目、刊物名称、出版日期、卷号、期号、起止页码列出List of Author(s) (please indicate whether the publication is co-authored with your supervised students, whether you are the correspondence-author, or whether authors share equal authorship), Article Title , Journal T
15、itle, Year of Publication, Volume #, Issue #, Pages刊物类别Journal Category收录、引用或转载情况No. of Citations12345678910序号#著作/教材名称Title of Published Book(s)全部作者排序List of Author(s)出版单位Published by出版时间Year of Publication著作总字数Total Word Count本人撰写字数Percentage of Personal Contribution12345统计 Total文科填写Humanities and
16、Social Sciences SSCI、SCI影响因子前1%刊物论文（第一或通讯作者，作者单位为中山大学）SSCI, SCI journals with top 1% IF（first-author or correspondence-author paper，authors work institution should be SYSU）国际顶尖A类学术期刊论文（第一或通讯作者）International top-A academic journals（first-author or correspondence-author paper）所属一级学科（及交叉学科）公认的权威期刊论文（第一
17、或通讯作者）Public-recognizedauthority journals in the first-level discipline or inter-disciplines of the field（first-author or correspondence-author paper）著作/教材：获得教育部高等学校科学研究优秀成果（人文社会科学类）二等奖或以上奖励（第一作者，作者单位为中山大学）Books: Second Prize or higher of Excellent Achievements Award for Scientific Research in Highe
18、r Educational Institutions by the Ministry of Education, China (for Humanities and Social Sciences) （first-author，authors work institution should be SYSU）总数Total作者单位为中山大学论文authors work institution is SYSU理工医科填写Science and Engineering，Medical ScienceScience、Nature、Cell等学术刊物及其高影响因子的子刊论文（第一或通讯作者）Scienc
19、e, Nature, Cell and their sub-journals with high IF（first-author or correspondence-author paper）本专业领域权威期刊论文（通讯作者）Authority journals in the field (correspondence-author paper）所属一级学科（及交叉学科）的权威期刊（即影响因子最高的1-3种期刊）论文（第一或通讯作者）Authority journals (one to three kinds of journal with highest IF ) in the first-
20、level discipline or inter-disciplines of the field（first-author or correspondence-author paper）收录为ESI的Top Paper论文（第一或通讯作者）Selected as Top Paper of ESI（first-author or correspondence-author paper）总数Total通讯作者且作者单位为中山大学论文correspondence-author and authors work institution is SYSU总数Total通讯作者且作者单位为中山大学论文c
21、orrespondence-author and authors work institution is SYSU所在单位审核人签名Reviewed by (from the Department/ School)：单位（公章）Official Seal：年月日 Y/M/D科研部门审核人签名Reviewed by (from the Department in Charge of Research Administration)：单位（公章）Official Seal：年月日 Y/M/D3承担科研项目（不含校内项目）Research Grants (university-level grant
22、s not included)序号#按项目来源及类型、项目名称、项目批准号、项目全部参加人员（注明主持人）、起止时间（注明计划完成时间、实际完成时间）、本人承担部分列出Source of Funding, Title of the Grant/Project(No.),List of Project Members(project director should be indicated clearly), Beginning & Ending Dates(planned ending date and actual ending date should be indicated), Port
23、ions Responsible.经费总数Grant(RMB)到帐经费Amount Received (RMB)12345678910统计Total国家级National Level Grant(s)部省级Ministry/Provincial Level Grant(s)厅局级Department/Bureau Level Grant(s)其他Other Grant(s)主持Project Director参加（前三）Participant(Top Three)主持Project Director参加（前三）Participant(Top Three)主持Project Director参加
24、（前三）Participant(Top Three)院系审核意见Verification by the Department/ School：审核人签字Reviewed by：单位（公章）Official Seal：年月日 Y/M/D科研主管部门审核意见Verification by the University Research Administration Department：已对申请人在本栏目填写的项内容，包括项目来源及类型、项目名称、经费、参加者排序、申请时间及结项时间、统计等信息进行审核。Information of the itemsin the above table has
25、been verified, including the source, type, title, amount(RMB), order of participants, beginning & ending dates and total number of grants/projects.审核人签字Reviewed by：单位（公章）Official Seal：年月日Y/M/D七、其他与申请本职位有关的情况Other Information(in relation to this application)（如社会服务情况、其他奖励等，可另附页）(State social and commu
26、nity services, administrative and school services, other awards, etc. Please attach separate sheet, if necessary)八、声明本人谨此声明以上所有资料及所附证明文件均属真实、符合学术道德规范，并可提供有关身份及资历文件的正本以供核实。本人明白倘若故意虚报资料或隐瞒重要事实，中山大学可取消已发出的口头或书面聘约，即使已获聘任亦可被解聘。I hereby declare that the information given above is true, correct, complete a
27、nd in accordance with the academic moral rule. Evidence about my identity and qualifications can be providedfor verification if necessary. I understand that any falsification or failure to state the truth will result in cancellation of appointment even if an oral /written offer has been made, or even if the appointment has begun.签名：Signature: 日期：Date (Y/M/D):填表说明Notes
