1、Instructions Before filling out the form, please carefully read the supporting document of BIT Teli Young Fellow Program. Application should be filled in Chinese or English carefully and precisely. Please use A4 double-sided paper to print the application form. The application form and the attachmen
2、t materials should be separately bound.一、简表 1.Brief Information姓名Name性别Gender国籍及籍贯Nationality照片Photo政治面貌Political Status民族Ethnicity证件名称Type of ID证件号码ID No.出生日期Date of Birth毕业院校Institution Graduated专业Major学位Highest Degree Awarded现工作单位Current Employer中文Ch职务Position英文EnglishEn博士导师Ph.D. Supervisor博士后合作导
3、师Postdoctoral Supervisor拟任职单位Current or Expected Employerxx学院Department主要研究方向Research Interests 教育经历（从本科起，按照时间正序填写，时间格式：YYYYMM）EducationalExperience（Starting from Bachelor Degree,Format: YYYYMM ）Degree起始时间Start Time终止时间End Time国家Country院校University工作经历（正序填写全职、兼职经历，兼职经历请注明）Work Experience （Please fil
4、l the full-time experiences in a chronological order firstly, then the part-time experiences and footnote them）（加注英文）Position 单位（加注英文）Employer 二、近五年主要学术成果、创新成果简介（本栏限2页）2.Description of Major Academic and Creative Achievements in the Past Five Years（No More Than Two Pages）三、申报人代表性成果3.Representative A
5、chievements3.1学术论文、专著总计3.1Representative Works and Papers发表论文数Papers共计Total（ ），其中第一作者First Author（ ），通讯作者Corresponding Author（ ）国外学术刊物International Journal（ ）国内学术刊物Chinese Journal（ ）SCI收录SCI cited journal（ ），SSCI收录SSCI cited journal（ ），EI收录EI cited journal（ ），CSSCI收录CSSCI cited journal（ ）出版学术专著数Work
6、s（ ）3.2近五年代表性论著、论文情况（10篇以内，第一作者或通讯作者，按照重要程度排序）3.2 Representative Works and Papers in the Past Five Years （Please list no more than 10 papers（the first author or the Corresponding Author） according to the importance）论文名称；发表刊物名称；期号、起止页码；所有作者姓名（通讯作者标注*号,共同一作请标明）Title of Papers, Units or Name of Publica
7、tions media: Year of Publication、Issue、Page, All the Names of the authors（Footnote the Corresponding Author by the mark of *and co-first author）发表年月Date期刊影响因子Impact Factor期刊类型（SCI、SSCI），分区Type of Periodicals（SCI、SSCI），Quartile in Category论文他引Cited Times （SCI、SSCI）3.3近五年申报人代表性著作情况3.3Representative Wo
8、rks in the Past Five Years专著名称全部作者Authors出版单位Publications Media出版时间本人执笔内容Main Contribution3.4 近五年承担主要科研项目（10项以内）3.4 Projects in the past five years （List no more than 10 projects）序号No.项目名称Name of the Project项目性质及来源Type and Source of the Project项目经费Grants起始年度终止年度主持/参与Leader/Participant本人排名/总人数Persona
9、l Ranking/Total Number of Participants3.5申请和获得专利情况3.5Application and Grant of the Patents已授权专利：共（ ）项目，按重要性填写专利Granted patents: , Fill out the form according to the importance of patents专利名称Title of Patents专利授权国Country Granting专利号Patent No.授权公告日Date of Granting排序Personal Ranking3.6近五年申报人重要科研获奖情况3.6 I
10、mportant Scientific Research Awards in the Past Five Years获奖项目名称Name of Awards 奖励等级Awards Level授奖单位及国别Unit and Country of Award奖励年度Year of Award排名/总人数四、入选后工作设想包括入选后的主要研究方向和思路、工作目标、预期贡献，现有基础、团队和需要的支持等。4. Work Plan （Including the direction, plan, objectives, expected contribution, current situation, w
11、orking team and support needed, etc.）五、申报人承诺5Declaration本人郑重承诺：1以上信息均真实有效，对因填报不实引起的一切后果由申报本人承担。2校外申请人如果成功获聘，自被批准之日起半年内辞去现任工作职务，全职到校到岗工作，否则将视为自动放弃该岗位。1. I hereby certify that the above information is accurate and true. If there is any false information, I am willing to bear all the resulting conseque
12、nces and responsibility.2. Since the application is approved, I will resign the position within 6 months and work full-time at BIT.申报人签字： Signature of Applicant: 年 月 日 Y M D六、所在单位意见6.Assessment and opinion of the department 6.1 学术评审 6.1Academic Accreditation应到人数Number of experts Being in the Team实到人
13、数Number of experts Participated表决结果（同意/总人数）Result（Agreement/Total number）/综合意见（Comprehensive opinions）:推荐意见： 特立青年学者 不建议引进Opinions: BIT Teli Young Fellow Not Recommended专家签名（Signature of the Experts）：专家组组长签字（Signature of the leader of the experts group）：_ 年 月 日6.2 基层党组织意见 6.2Assessment and opinion of
14、 the party organization（基层党支部填写，对于非中共党员，由学院党委进行填写）由基层党支部对申报人思想政治表现进行评议。党支部书记签字: 单位（党章）Signature： stamp 6.3 学院综合意见6.3Comprehensive opinions负责人签字： 单位（公章）： Signature stamp七、学校评审组意见7.Assessment of the experts team 综合评价（Comprehensive opinions）：专家签名（Signature of the Experts）:_八、学校审定意见8. Assessment and Opinion of the University 单位（公章） Signature of the Head of Employer： Stamp 年 月 日
