1 0M.
em-t^ Thong tu s6 06/2016/TT-BGDDT ngay 21 thtag 3 nSm 2016 c^a BO
GiSo due v^ Dao tao ban h^nh Quy chO tuy^n sinh di hpc nude ngoM v4 thOng bao chi tieu hpc b6ng nSm 2021 d^nh cho Viet Nam cua Phong Tham t^n Van hoa - D^i s^
qudn Trung Qu6c tai ViOt Nam, B0 Gido d^c vd Ddo tpo thong b4o tuy^^n sinh di hpc tpi Trung QuOc n8m 2021 nhu sau:
1.Thong tin chnng ve chirong trinh hpc bong 1.1. Trinh ^p dao tgo va nganh hpc
Chinh phu Trung Qu6c c^p 44 hpc b6ng todn phfin cho c6ng dSn ViOt Nam di hpc ti6n ^I, thpc sT va dpi hpc tpi Trung Qudc.
1.2.Th(rigiandhotpo
-Chuong trinh ti^n si: tit 03 d^n 05 nam hpc.
-Chuong trinh thpc si: tit 02 din 04 n8m hpc.
-Chuong trinh dpi hpc: tit 04 din 05 n8m hpc.
1.3. Chi dp hpc b8ng
Chinh phO Trung Quoc miln hpc phi cho qud trinh hpc tp, bl tri chS (s, cap bdo hilm y tl, tai lipu hpc t|p vd hpc blng hlng thdng theo mire quy djnh cua Chinh phO Trung Quoc.
2.Boi tirong, dieu kif n vd ho so du so tuyln 2.1. Biiukipn chung
Ung viSn dyr tuyln cdn dap ling ddy du ede dilu kifn chung sau ddy:
-C6 phlm chit chinh trj, dpo ditc tit, kh6ng trong th^i gian thi hanh ky lupt ho^c trong thM gjan dang bj cu quan c6 thlm quyen xem xdt xii 1^ k^ lu|t;
-Bu s6c khOe dl hpc tpp tpi nuOc ngodi, khOng mang thai (dli vdi ntt), khi nhap hpo vd djnh ky hlng n8m phfa Trung Qulc s6 tl chile khdm lpi sire khOe. TruOng hpp bj phdt hiOn c6 bfnh, khong du sure khOe do gid mpo hi so dl di hpc s6 phai vl nude vd t^
chju mpi chi phi HSn quan, kl cd vd mdy bay;
-Chua dang ky d\r tuyln chuong trinh hpc blng ndo dl di hpc 0 nude ngodi trong n8m 2021;
CONG VAN DEN.THONG BAor- ^ 86 JLLTUYEN SINH BI HQC TAI TRUNG QU6CNAM 2021
BQ GlAO DQC VA DAO TAOCQNG HOA XA HOI CHU NGHIA VE|T NAM
.. Doc lap - Tu- do- Hanh phuc
Sl^42 ^B-BGDDTHaNpi.ngayl5th6ng01nam2021
HQC VIEN TAI CHINH^ ^^'
-Cam ket hodn thdnh chiromg trinh ddo tpo va trd vd phpc vu tei ca quan cd di hpc hoac theo ydu cau ciia Nha nude;
-Ng^nh hpc dang ky dp tuyin phdi phii hpp vdi nganh d3 hpc dai hpe/thae si, cdng vipc dang lam;
-Chi dupe dang k^ 01 nganh hpc (xem thong tin chi tiit thdm Pdn website:
http://www.csc.edu.cn/studvinchina hoac http://www.campuschina.orgl va khdng dupe tu y thay doi nganh hpc, co sd ddo tpo sau khi da dang ky dp tuydn, thing tuyen di hpc theo thong bdo cua Bd Gido due va Bdo too Viet Nam, tiy ban Quoc gia QuJ* hpc bong Trung Qu6c vd cp sd dao t^o t^i Trung Qudc;
-Chi dupe dang ky du tuyln trinh d dao tgo cao hon trinh d$ da cd van bang;
-YSu c^u vS ngo^i ngtt: Ng6n ngft sd dung trong hpc tap vd nghi^n cdu la ti^ng Trung ho^c ti^ng Anh, tag vien dp tuy^n phdi dap tag mpt Pong ede quy djnh dudi ddy:
+ C6 chtag chi HSK cdp 4 Pd 16n cdn hi^u lpc sd dung ho|c cd bang dpi hpc, thac sthpe tpi Trung Qu6c bang ti^ng Trung Qudc (doi vdi trudng hpp dp hiyen di hpc bang tieng Trung Quoc);
+ Cd chdng chi tieng Anh TOEFL ITP 500 dim ho|c IELTS 5.5 Pd ldn ho|c Prong duong do co quan quoc t cd th^m quy^n cap cdn thdi han hi^u lpc sd dpng ho|c cd bdng dai hpc, tl^ic sT hpc bang t^ing Anh d nude ngodi (doi vdi trudng hpp dp tuyen
di hpc bang tidng Anh);
+ ting vien dp tuy^n n^u chua cd ngo^i ngd thi dupe dang k^ dp tuy^n d^ di hpo bang tieng Trung Qudc (dupe b6 Pi hpc 01 n^m dp bj tidng Trung Qudc t^i Trung Qudc) vk phdi vupt qua dupe k^ thi sat hach ting Trung Qu6c do Chinh phd Trung Quoc td chdc Pudc khi vko hpc chuydn nganh.
-Bap tag cic quy djnh hi^n hlnh vd ddo tpo, b6i dudng cdng chdc, vidn chdc (d6i vdi tag vidn la cdng chdc, vidn chdc).
-Khdng xdt tuyln dng vidn thupc clc trudng hpp sau:
+ Da tung dupe co quan Nhl nude cd di hpc d nude ngoii nhtmg khdng hota
th^nh khda hpc ho|c khdng thpc hi^n vide bio do tdt nghipp theo quy djnh;
+ Bang lto vide t^i co quan Pong nude nhung Ididng cd v8n bin cda co quan quan I^ true tidp ddng ^ cd dp tuyen;
+ D3 dupe dip hpc bong di hpc dai hpc/sau dai hpc d nude ngoli, hi^n cd ede ring budc vl nghia vp, Pach nhipm ho|c thudc di^n bdi hodn kinh phi ddo tao;
+ Da dupe tuy^n chpn di hpc nude ngodi nhung khdng di hpc vi \^ do ci nhn (thdi han dp dpng Id 02 n3m ke td ngay npp don xin nit khdng di hpc).
Xem chi tiit tpi Php lpc 3 Xem chi tiet
tpi Php lpc 2 Xem chi tiit
tai Phu Ipc 1 H6 sa dp sa
tuyen bang
tiing Vipt
Hpc sinh dang hpc ldp 12 dopt giii tpi cic ky thi Olympic quic td hoic quoc gia thu$c ddi tupng dupe tuyin thing vio dpi hpc theo quy chi tuyen sinh dpi hpc hi^n hinh, cd kit qui hpc tip d bpc THPT din hit nim hpc 2020 - 2021 dpt tu 7,0 trd len.
- Ngudi tdt nghi^p dai hpc lopi khi trd ldn, dang cdng tic tpi cic ca quan nhi nude, cic ca sd giio due dai hpc (bien chi hoic hpp ddng tir 12 thing trd ldn cd ddng bio hiim xa h$i), khdng qui 35 tudi (tinh din ngiy 31/01/2021), cd thdi gian cdng tic tdi thiiu 12 thing ki tir khi cd hop ddng lao ddng
diu tidn tinh din ngiy hit han ndp hd so du tuyin theo
Thdng bio niy; Hipn khdng dang theo hpc chuang trinh thpc si trong hoic ngoii nude.
- Sinh vidn t6t nghifp dpi hpc trong vdng 12 thing tinh din ngiy 31/01/2021 (da dupe cap bang vi bing diim chinh
thdc) vdi kit qui hpc tap dpt lopi gidi trd 16n, trutag hpp tag vi6n tdt nghidp tpi Trung Qudc cin dpt tir 90/100 diim trd 16n; chua cd quyit djnh tuyen dpng ho^c hpp ddng lam vide, hpp ddng lao ddng, cd cam kit sau khi hoin thinh khda hpc s6 vi nude lim vi$c theo ydu ciu cda Nhi nude.
- Nguoi c6 trinh d^ thpc sT, cd diem trung binh chung khda hpc thac si tir 7,0 trd len (theo thang diim 10 ho^c tuong ducrng), dang cdng tic tpi cic ca quan nhi nude, cic cor sd gido due dpi hpc (bien che hoic hpp ddng 12 thing trd len cd ddng bio hiem xi hoi), khdng qui 40 tudi (tinh den nj>iy 31/01/2021), cd thai gian cong tic tii thilu 12 thing ke tir khi cd hpp ddng lao dpng diu tien sau khi tdt nghiep dpi hpc, thpc si, tinh din ngiy hit hpn ndp hd so dp tuyin theo thong bio nay; hien khdng dang theo hpc chucmg trinh nghien eta sinh trong hoic ngoii nude.
- Hpc vien tdt nghidp thac si trong vdng 12 thing tinh dSn
ngiy 31/01/2021 (da dupe cip bing vi bing diim chinh
thdc) vdi kit qui hpc t^p dpt tir 8,0 trd len (theo thang diim 10 hoic tuang duang), trudng hpp tag vien tdt nghiip tpi Trung Qudc cin dpt ttr 90/100 diem trd len; khdng qui 35
tuoi (tinh din ngiy 31/01/2021), chua cd quyit dinh tuyin
dyng hoic hpp ddng lam viic, hpp ddng lao dpng, cd cam kit sau khi hoin thinh khda hpc si vi nude lim vipc theo ydu ciu ciia Nhi nude.
Boi tirpng va dieu kien cu thi
Hoc bdng
dai hpc Hpc bong thac sT
Hoc bong tiinsl
Hoc bong
dir tuyen
2.2. Bdi iucmg, diet* kien cu thi va ho sff dtt sa tuyin bSng tiing Vift
TL. BO TRlTdNG
KT. CUCTRTTONG CUC HOP TAC QUOC T^
NainhSn:
-Cac Bp va ccr quan ngang B$;
-UBND cac tinh/thinh ph6;
-CiSc DH, hqc viOn, tniong DH, CD;
-BO tnrong (de b/c);
-Cac Thd tnrcrng (dl b/c);
-Cue trvcmg (de b/c);
-Websites: www.moet.eov.vn:
www.icd.edu.vn:
-Bdo Gi^o due va ThM d^i;
-Luu: VT, HTQT.
3.Quy trinh nyp hi sof dang ky so tuyen
3.1.Npp ltd scrtmc tuyen (online) ddng thfritai 02 din chlsau:
3.1.1.Ho so- tiing Viet: Ung viSn ph^i qudt (scan) luu lai todn b6 hi so sang cdc files dinh dyng PDF (mii loyi tai liyu quet thdnh 01 file rieng dung luyng khfing qud 1 MB) de dang k^ tryc tuyin t^i https://tuvensinh.vied.vn/ truto ngay 06/02/2021.
3.1.2.Ho so tiing Trung/tieng Anh: Uhg vien phdi dang k^ hi so tiing Anh/tiing Trung tren cdc website: httD://www.csc.edu.cn/studvinchina ho(ic www.campuschina.org trirfrc ngay 06/02/2021.
3.2.N0p ltd sffgidy
ling vien chuyen 01 b hi so gidy tieng ViSt (theo phy luc 1, 2, 3) vi 02 bp h6
so giSy tieng Trung/tieng Anh (theo phu luc 4) bang thu chuyen phat nhanh bao d^m tdi Cue Hyp t^c qu6c te - Bp Giio due va Dio tao, 35 >ai C6 Vift, Quan Hai Bk Trung, Ha Npi tru^c ngay 06/02/2021 (tinh theo dSu buu di^n chuyln h6 so din Cyc Hyp tac qudc ti).
Ho so can dung trong hii ho so kich thudc 25cm x 34cm, mat ngoai ghi day dii thong tin chi tiet theo Phy lye 1, 2,3,4 quy djnh doi vdi h6 so dy tuy6n hyc bong di hyc tyi Trung Qu6cnam2021.
H6 so hyp 1? la h6 so c6 dil ede giay tb quy dinh doi vdi hoc bdng dy tuySn, duyc nyp trong thbi han quy djnh cua ThSng bio tuyen sinh (bao gom cd h6 so online vd h6 so gidy). Ngubi khai h6 so dy tuyen khdng ddng va ngubi xdc nhn sai s6 bi xtr ^^
theo phdp ludt. B^ Gido dye vd Ddo tyo khong trd lai h6 so dy tuyin trong bat ky trubng hyp nao.
(Xem them thong tin, ede mdu vdn ban liin quan tai websites: www.moet.eov.vn:
www.icd.edu.vn:http://www.csc.edu.cn/laihua; lien h^ ho try ky thuat khi ddng ky d\f tuyen theo dja chi info@vied.vn, tuyensinh@vied.vn).
4.Qny trinh xet tuyin
By Gido due vd Ddo tyo sg xem xdt ung vidn dy tuyen cd ho so ddy dil, hyp 16 theo quy djnh va cdn cii ede tidu chi tuyen chyn s6 so tuyen ling vi6n de de cdr vdri phia Trung Qu6c. Cue Hyp tdc quoc ti - By Gido dye va Ddo tyo thong bao kit qua so tuyen din ling vidn qua email vdo ddu thdng 5/2020.
^Tng vien duyc Chinh phii Trung Qu6c duyet cdp hyc b6ng mdi thuOc di6n tning tuyin di hyc tyi Trung Qu6c trong thdng 8/2021 hodc thdng 9/2021.
B6 Gido dye va Ddo tao di nghj ede co ^uan tao dieu kifn thu^n lyi cho tog vidn c6 du diiu ki6n cdn thiit duyc tham gia dy tuyin dung thbi han quy djnh./.
Phu lye 1
h6so
Dtf TUY^^N HOC BONG DI HOC TAITRUNG QU6C NAM 2021 (Theo thong bdo so ^^j /TB-BGDDT ngay /3/01/2021)
Trinh do dang ky dur tuycn: TIEN Si Nganh hoc dang ky dytuyen:
Hyvdten:Nam, Nil:
Ngay, thang, ndm sinh:
Co quan cdng tac (d6i vdi ngudi dang c6ng tde) ho^ic co so giao due vira t6t nghipp (doi vdi ngufri chua cong tac);
Nganh hyc da tot nghiip:~..—•
H6 khdu thuong trii:
Dia chi lien he, sd dien thoai cd djnh vd di dyng, e-mail (neu cd):...
H6 so dy so tuyn (01 bo) bang tieng Viet gom cac tai lieu trinh bay tren giay khd A4, theo chieu doc trang giay va xip theo thir ty dirdi day:
1.C6ng van cua co quan cu dy tuyin d6i vdi, ung vien cd co quan cong tic; trudng hyp ting vien la nguoi chua di^am thi nop ban cam ket ve vi^c lam;
2.Phi^udang_kydutuy&i(Miu01);_
3.Ban cam k6t nghia vu cua luu hgc sinh duyc cur di hpc nude ngo^i (MSu 3a doi vdi ting vign co cq quan cong tac; Mau 3b doi vdi ung vien chua co co quan oong tie);
4.So ySu ly lich dupe ddng dlu giip lai v^o anh vh c^c trang dung quy djnh. Luu f k^ khai du thbng tin, ki ca muc khen thudng, ky luat; Ngudi dang cdng tdc ph^i si) dyng M^u 2c- BNV/2008, ling vien chua cq.co quan cong tac si) dung Mau 5;
5.B&n sao cdng chiing cac quydt djnh tuydn dung, thuyen chuyen cdng t^c, hyp ddng l^m viyc, hyp ddng lao dyng;
6.Ban sao cdng chiing sd bao hidm x^ hdi ddi vdi trudng hop ung vidn Id ngudi lao ddng hyp ddng (khdng phai la cdng chiic^ vien chtic) hodc giay xac nhan ddng bao hiern xd hdi do co quan cdng tdc va co quan bdo hiem xd hi xde^han neu chua duyc cdp sd bdo hiem xd hdi;
7.Ban sao cdng chiing bang tdt nghiep, bang didm todn khda d^i.hyc va th?c si (trudng hyp vSn bing do nude ngodi cdp phai nop ban djch cdng chiing sang tieng Vi^t);
8.Bdn sao cdng chiing giiy chiing nh^n vSn bdng niong duong do Cyc Quan iy chit luyng - Bd Gido dye vd Ddo tao cap (ddi vdi trudng hyp tdt nghidp dyi hyc, thyc si d nude ngodi khdng do By Gido dye vd Ddo tyo cu di hyc vd quan ly);
9.Bdn sao cdng chiing quydt djnh cii di hyc d trinh d$ dd t6t nghidp vd vSn bdn tiip nhdn vi cda don vj cii dj (ddi vdi nhOng trudng hyp do ede b$/nganh cua Viet Nam cii di hyc);
10.Tdm tit di cuong nghien ciiu trong khodng 02 trang khd giay A4 cd xdc nhdn cda co quan ciidutuyin;
11.Danh muc ede cdng trinh nghidn ciiu dS cdng.bi ho^c giay cdng nhdn cdng trinh nghien cuu (ndu cd) cd xdc nhdn cua co quan cd thdm quyen;
12.Ban sao hop If chiing chi ngoyi ngtt ding Trung/tiing Anh (niu Cd);
13.Gidy khdm siic khde cd xdc nhan dd diiu ki^n di hyc nude ngodi cila b^hh vi^n da khoa cap tinh, thdnh pho (tham khdo Mdu'6);
14.Kit qua xet nghi^m HIV (niu chua cd trong giiy khdm siic khde);
15.Cac giiy td khdc (niu cd).
Liru v: Cac ban sao, bdn djch phai co xdc nhdn cua co quan cd thdm quyen; mdi loqi gidy td neu nhieu hem 01 trang thi phai cd ddu gidp lai; gidy td cd anh can dtege ddng ddu gidp lai vdo
anh.
Phu luc 2
HO SO
DlTTUYEN HQC BONG BIHQC T^I TRUNG QUOC NAM 2021 (Theo thong bdo sd 4& /TB-BGDBT ngdy/S/0I/2021)
TrinhdodSngk^dutuyn:THi\CSl
Nganh hoc dang ky dutuyln:, Hpvitdn:.Nam.Nu:
Ngay, thing, nam sinh:
Co quan cfing t^c (ddi vdi ngudi dang cdng tic) hoic ccr sd giio due vCra t6t nghiep (doi vbi ngudi chua cong tic):,
Nganh hoc da t6t nghifp:
Hp khau thudng tru:
Bia chi lien hf, s6 dien thoai cd djnh va di dpng, e-mail (ndu c6):
Ho so dyr so' tuy^n (01 bp) bang tieng Viet gdm cac tai lieu trlnh biy tren giay kho A4, theo chieu doc trang giay va xep theo thir tir duoi day:
1.C6ng vin cua ccr quan tit dtr tuy^n doi vdi ling vidn cd co quan cong tic; trudng hop ling vien moi tot nghiep dai hoc chua di lam thi npp ban cam ket v^ vi^c lam;
2.Phiiu ding ky du tuyin (Mlu 01);
3.Ban cam k^t nghTa vu cua luu hoc sinh dupe cii di hpc nude ngoai (Mlu 3 a d6i vdi ling vien cd ccr quan cong tic; Mlu 3b d6i vdi ling viSn chua cd co quan cong tic);
4.So yeu ly ljch dupe ddng dau giip lai vao anh va cac trang diing quy djnh. Luu ^ k khai dii thong tin, ki ca muc klien thudng, ky luit; Ngudi dang cdng tic phai sii dyng Miu 2c-BNV/2008, ling vi^n chua cd co quan cong tic sir dung Mau 5;
5.Ban sao cong chiing cic quyet djnh tuydn dpng, thuyen chuyen cong tic, hop ddng lim vide, hpp ddng lao dng;
6.Bin sao cdng chiing sd bio hilm xa hpi d6i vdi trudng hpp ling vien li ngudi lao dpng hpp ddng (khdng phai la cdng chiic, vien chiic) hpic giiy xac nhan ddng bip hidm xi hpi do co quan cdng tic vi co quan bio hidm xi hi xic nhin ndu chua dupe cap sd bio hidm xa hi;
7.Bin sao cdng chiing bang tdt nghiep, bing didm toin khda dai hpc (trudng hpp vSn bing do nude ngoai cap phai ndp bin dich cdng chiing sang tieng Viet);
8.Bin sao cdng chiing giay chiing nhan van bang tuong duong do Cue Quan \^ chit lupng - Bp Giio due vi Bio tao cip (doi vdi trudng hpp tdt nghiep dai hpc d nude ngoai khdng do Bd Giio due va Bio tao cu di hpc vi quin ly);
9.Ban sao cdng chiing quydt djnh cii di hpc d trinh dp da t6t nghidp va v5n bin tiep nhin v6 ciia don vj cii di (doi vdi nhung trudng hpp do cic b$/nginh ciia Viet Nam cii di hpc);
10.Danh muc cic cdng trinh nghien ciiu dS cdng bd ho^c giiy cdng nh^n cdng trinh nghien ciiu (neu cd) cd xac nhan ciia co quan cd tham quyen;
11.Bin sao hpp le chiing chi ngoai ngu tiing Trung/tieng Anh (neu cd);
12.Giay kham siic khde cd xac nhin dii didu kipn di hpc nude ngoai ciia bfnh vifn da klioa cap tinh, thinh phd (tham khio Mau 6);
13.Ket qui xet nghipm HIV (ndu chua cd trong giiy khim siic khde);
14.Cac giiy td khic (neu cd).
Liru v: Cac ban sao, ban dich phai cd xic nhan cua ca quart cd tham quyen; moi loqi giay td neu nhieu ban 01 trang thi phai cd dau giap lai; giay id cd anh can dupe ddng dau giap lai vao anh.
Ho so dy so tuyen (01 bo) b3ng tieng Viet gom cic tii Iif u trinh hiy tren giay kho A4, theo chieu d^c trang giay vi xep thco thir ty dir^i day:
1.Phieu ding ky dy tuy^i (Miu 02);
2.Bin cam ket nghTa vu cila luu hoc sinh duoc cOr di h^c nude ngoii c6 y kiln bio lSnh vi chO ky ciia bo, m? ho^c ngudi d^i di?n hyp phip;
3.So ylu 1^ ljch c6 din inh vi xic nhin cia UBND phudng/xS noi cu tni hoc cila co sd giio dye d^i hpc dang theo hpc dupe ddng diu giap lai vio inh vi cic trang diing quy djnh. Luu
•j ke khai du thong tin, kl ca myc khen thudng, ky lut (Miu 5);
4.Bin sao cong chung giiy khai sinh doi vdi dng vien li ngudi din tpc thilu s^;
5.Bin sao cdng chdng hpc ba THPT din thdi dilm dp tuyen;
6.Bin sao cdng chdng giiy bio dupe tuyln thing vio dyi hpc;
7.Bin sao cdng chdng bang khen, giay khen, giay td ohdng nhan cic giii thudng qudc tl, khu vyc, qudcgia,...(neucd);
8.Bin sao cdng chdng h khiu thudng trd (dli vdi dug vidn thu^c dli tupng uu tidn vilng, miln theo quy djnh hifn hinh);
9.Ban sao cdng chdng giiy chdng nhin con li^t si, thi thuong binh cda bl/m? di (nlu cd);
10.Giiy khim sdc khde cd xic nh^n du dilu ki?n di hpc nude ngoii cda bfnh vifn da khoa cip tlnh, thinh phi (tham khio Miu 6);
11.Kit qui xet nghifm HTV (hlu chua cd trong giiy khim sdc khde);
12.Cic giiy td khic (nlu cd).
Lieu v: Cdc ban sao phdi cd xdc nhan cua ca quan cd thdm quyen; mSi loqi giay td niu nhiiu hern 01 trang thi phdi cd ddu gidp lai; giay td cd dnh cdn du^e ddng ddu gidp lai vdo dnh.
HO SO
DV" TUY^N HQC BONG DIHQC TAITRUNG QU6C NAM 2021 (Theo thong bdo sd 4Z> /TB-BGDDT ngdy/S/01/2021)
Trinh a aing l^^ dy tuyen: BAI HQC
Nginh hoc ding ky dytuyln:
Hpviten:Nam,Ntt:
Ngiy, thing, nim sinh:..,,....,,
Trudng dang hpc tyi Vift Nam:
B^t giii Qudc gia mdn:..., HO khiu thudng trii:...-
Bja chi lifn hf, si di^n thoai ci djnh vi di dOng, e-mail (nlu cO):
Phu luc 3
H6 so dy tuygn 02 bp bdng tieng Trung/tigng Anh gom cac tai lieu trinh bay tren giay kho A4, theo chieu doc trang giay va xep theo thi'r ty dirdi day:
1.Phieu d^ng ky dy tuyen hoc bong Chinh phu Trung Quoc (mau quy dinh cua CSC);
2.Ban djch cong chiing bing vd bang di^^m dpi hpc (d6i vdi ling vien dy tuyen hoc b6ng thac si), Ban dich hgp le bdng va bang diem thpc si (d6i vdi ling vign dy tuyen hpc bong ti^n si), Ban dich hyp lp hpc bp va chung nhpn tuyln thing (d6i vdi ling vien dy tuyin hpc bong dpi hpc);
3.Kg hopch/dg cucmg hpc tSp/nghien ciiu (t6i thiSu 500 tir doi vdi ling vien thac si va 800 tur d6i vdi ung vien tiln si);
4.02 thy gidi thi^u ciia 02 nha khoa hpc cd trinh d tiSn si ve nganh hpc dang ky dy tuyen (doi vdi ling vien hpc bdng thac si, tien si);
5.Danh muc cdc cong trinh nghien ciiu dd dupe cdng bd ho^c giiy cdng nhdn cdng trinh nghien ciiu (ngu cd);
6.Giiy kham siic khoe cho ngudi di hpc nude ngoai cua bgnh vipn trung uong/tinh/thdnh phd (theo mlu quy djnh ciia phfa Trung Qudc), trong dd xdc nhpn du dieu kign di hpc nude ngoai, khong mang thai (doi vdi ntt) va cd thdi gian kh^m edeh khong qud 06 thdng tinh den ngay 31/01/2021 (Mlu kgm flieo);
7.Ban sao cdng chiing chung chi ngopi ngtt tigng Trung/tilng Anh (nlu cd);.
8.V5n ban dy kign tigp nhpn ciia co sd ddo tao tai Trung Qudc (ngu cd);
9.Bdn photocopy hd chilu phd thong;
10.Cdc van bdn khdc (ngu cd);
11.02 anh 4x6 cm ngn trlng.
Luu ^;;• •
Moi loai giay to rdu nhieu hon 01 trang thiphdi co ddu gidp lai; giay tct co anh can dupe dong dau gidp lai vao anh.
Bia chi lien he, so di|n thopi co dinh va di d^ng, e-mail (neu co):.,
H6 SO TIENG TRUNG/TIENG ANH
DV TUYEN HQC BONG BI HOC TAITRUNG QUOC NAM 2021 (Theo thong baa sd 4Z> /TB-BGDDT ngdy 45/01/2021)
Trinh dp dang ky dy tuyln (ThS/TS/BH):
Nganh hoc dang ky dy tuygn:
Hpvatgn:...Nam, NO:
Ngay, thang, nam sinh:, Ca quan cdng tac:
Nganh hpc da tot nghiep:,
Hp khau thudng tni:,
Phil luc 4
5. Trinh d$ hpc v^n (cao nhit): O D^i hgc D Thpc si D Ti^n si
K^t qui hoc tp {ghi rB loqi TB Khd, khd, gidi, mat sBc):„„„_
(niu kMngphai la thang diim 10 thl cdn kirn theo ban sao thdng tin vi thang diim, xip loai cita nai Ape).
Neu dS hpc tai nude ngoii, dl ngh; ghi rC thong tin cic hpc bong/nguon tii try di dupe hudng dl di hpc nude ngoii:
D DH: nude di hpc_lopi hpc b6ng:....^,...
D ThS: nude di hpc, lopi hpc blng:,.,„.., D NCS: nude di h9C,,, lopi hpc blng:.
DITS: nude di hpc....„„, lopi hpe bdng:...
GAi cAii: Logi hpc bong niu <S> trin cdn diin sd at thi theo m^t trong ede n^i dung duoi ddy:
(1)Hpc b^ng do ngan sach Nhi nude Viet Nam clp (BO Giio dye vi Bio tyo cti di hpc);
(2)Hpc bOng theo cic di in dio t?o phoi hpp dupe BO Giio dye vi Bio tyo cip kinh phi;
(3)Hpc bdng diOn HiOp djnh (BO Giio dye vi Bio tyo cd di hpc);
(4)Hpc bdng do co sd dio tpo nude ngoii/co quan, t6 chdc quoc ti cip (ghi rd tin noi cip hpc
blng);
(5)Nguin tii trp khic hoc ty tie kinh phi (cin ghi rd thdm dudi diy):
Di?n tho?i: Co quan,^..Nhirieng..
DBE-mail:
ThuOc BO, Nginh, Tinh:.
4. Bja chi gui thu:
Maul
BQ GIAO DUC VA BAO TAOCONG HOA XA HOI CHU NGHIA VIET NAM
Bpc lip - Ty do - Hanh phuc
PHlEU BANG Ki DXJ TUYEN BIHQC SAU B^I HQC TAITRUNG QUOC
ThOng bio da tuyln: 41/ /TB-BGDBT ngky/SlO1/2021 Trinh fl$ dy tuycn (ThS, TS):
Nginh hpc dy tuyin:
Ngoai ngft si dung hoc d mrdc ngoii:...,
1.Hg vi t&i:„^Gidi tinh: D Nam D NO.
2.Ngiy, th^ng, nSm sinh:
3.Chic vy vi co quan dang c6ng tic:..
:.^.,,.,..,.^.ngtiy '[V t /2021
l2m(ChiikynguMdvtuyin (ChSky thu truing dan vva ghi rS hg ten) ding ddu va ghi ro hg ten)
6. Nhan xet, d^nh gi^ phlnj chit d^o diic, ili sing (do Thu tnidng co quan cong tac, co quan
gidi thi?u dy tuyln ghi):
(ChHk^ngu(HdVtuyin (Chii ty thil tru&ng don v\,v^ ghi rd hp tin) SongdduvdghirdhQlin)
XACNHANCOaCOQUANCO'DV'TUYEN....^_..,ngdy / 12021 Mau2
BO GIAO DUC VA BAO T^OCONG HOa XA H0I CH1J NGHIA VIET NAM
Dpc lap - Tu- do - Hanh phiic
PHEEU DANG K^ DV TUYiN DIHQC BAIHQC TAITRUNG QUOc
Thong bio dytuyln: 4^ /TB-BGDBT ngiy/^/01/2021
Nganh hijc du tuyen:,„
Ngoai ngfr sir dung h^c <r nude ngoai:
1.H<? vi ten:..,.._„Gidi tfnh: ? Nam ? Nu.
2.Ngiy, thing^ nm sinh:...-^....^-^
3.Giiy CMND/The cincudc congdins^:ngaycip:
Ncricap:„
4.H$ chieu so:,Ngay cip:
Noi c^p:...,,.,- 5.Bja chi g^^i thu:--
Bi$n tho^i li^n hf^E-mail:„.,...,
Trinh dO hoc vln (cao nhat): U Trung hijc ph6 th6ng ? Cao ding D B?i h^c 6.Qui trlnh hpc t^p:
6.1Trung h^c pho thong:
Truirng:
Biim Trung blnh h^c tip: Lop 10: Ldp 11: Lop 12:
Biim tit nghi?p THPT:„
6.2B^i h(?c/Cao ding:.._^
Thin gian dio t^o: nim.TCrdin
Tnrdng: ,_._
Nude:
He dio tao: o Chinh quyD T?u chuc? Khic (ghi r8)
Nganh dio tao:,...
Bilm trung binh hQC t^p cic k^ h^c:
7.Trinh dO ngo^i ngu: aCdchdngchiD Chua cd chiing chi
TiingAnh:IELTSTOEFL. Ngiy cip:...Noicip„„.
Tiing Tnmg: HSK,Ngiy cip:...Noicip
Xac nhan bdo ldnh cua ca quan tuyln chpn vd gidi thipu ngudi dy tuyln:
xac nhpn bdo Utah 6ng/bd hien dang la (bien chl/hpp ding)ctia
.,Chung tdi cam kit thyc hien trdch nhifm:
1.Tiep rihjta lpi vd bl tri cdng tac phii hpp vdi chuydn mdn vd trinh d ddo tpo sau khi tit nghifp d
nude ngoai ve.
2.Giup dd, tpo dilu kidn dl dng/bd cd tdn Udn dupe tilp tyc ddng bdo hilm x5 hi trong thdi gian di ddo tao d nude ngoai.
3.Phdi hpp vdi cac ca quan lidn quan trong vi^c ydu clu dng/bd cd tdn trdn thyc hi^n ddng nhOng cam kit neu ttdn.
„....ngay thangn&m 2021
Thu trudng/Gidm dlc/Hi^u tnrdng Ky, ghi rd hp ten vd ddng dau Khi dupe Nha nude cu di hpc tpi nude ngodi, tdi tp nguy^n cam kit thpc hif n ede nghia vu sau:
1.Chip hanh nghiem tide Quy chl qudn ly luu hoc sinh d nude ngoai, quylt djnh cut di hoc ctia Bp Gido dye vd Ddq tao vd chap nh|n cac quy djnh hin hdnh cua Nhd nude vl tdi chinh.
2.Khdng xin chuyen trudng, chuyen nude ho&c thay ddi khoa hpc, chuang trinh hpc. Cam kit tich eye hpc tap, nghien ciiu dl hoan thanh tit chuang trinh ddo tao dung thai han dupe phep.
3.N^u phai gia hpn thdi gian hpc t^p s6 ty tdc kinh phi trong thdi gian gia hpn. Ndu khdng chdp hdnh nghia vy cua luu hpc sinh dupe cap hpc blng sd boi hodn kinh phi theo qui djnh cda Nha nude.
4.Trong qud trinh d nude ngoai, toi ddng y dl traong va ca quan di tni nude sd t?i cung cap thong tin vl ban than cho ca quan clp hpc bong hodc cac ca quan nhd nude khac cua Vit Nam (trong do bao gdm Ca quan dpi dien) khi dupe ca quan clp hpc blng uy quyln.
5.Sau khi kit thuc khoa Iiqc vl nude ngay vd thyc hi^n thu tyc bdo cdo tit nghi|p vdi B| Giao dye vd
Ddo tao.
6.Cam kit ldm vi^e lau ddi cho cp quan/ca sd gido dye dd cur tdi di hpc ho|c theo sy dieu dpng cua Nhd nude.
Tdi xin cam kit thyc hipn dly du nhOng dilu ndu trdn vd ede quy djnh hi|n hdnh khdc cd lidn quan.
Nlu khdng thyc hi^^i dung bdn cam kit ndy, tdi xin bdi hodn todn bp chi phi ddo too vd hodn todn chju trach nhiem vl vipc xu ^^ kj lu^t theo ede quy djnh hin hdnh cda Nhd nude.
, ngaythongnim2021 Ngudi cam kit lty vd ghi rd hp tdn Ten t8i la:_^Sinh ngay
CMND s6:Ngay clp:„Nai clp:.
Hp chieu so:,Ngdy clp:,,Nai clp:.
Hien nay la:„,„,
Mau3a
CONG HOA XA HQl CHU NGHIA VIET NAM
Doc lap - Tit do - Hanh nhiic
BAN CAM KET
THVC HI$N NGHlA VV CUA LUU HQC SINH
Kinh gdri: B| Gido dye vl Ddo tao
Ten t6i la:^Sinh ng4y .„,..,.
Giay CMND/TM c4n cudc cong dan s6:Ngay dip:Noi cap:
Hp chieu s6: ,Ngay dip:„_„Ncri dip:- Hifn nay 14:„„
Khi dupe Nha nuac cii di hpc t^i nude ngo4i, t6i ty nguyfn cam ket th\rc hi^n cac nghla vu sau:
1.Chip hanh nghiSm tiic Quy chS quan ly luu hpc sinh 6 nude ngoai, quyet djnh cir di hpc cua Bp Gi4o dye v4 Dao tpo v4 chip nhan c4c quy djnh hipn hanh cda Nha nude vi tai chinh.
2.Phin diu hpc tap, nghicn cuu di hoan thinh chucmg trinh d4o tpo dung thai hpn.
3.Khong xin chuyin trudng, chuyin nude ho^c thay dii kho4 hpc, chuong trinh hpc. Cam kit tich eye hpc t^p, nghiSn cdu di hoan thanh tit chuorng trinh dao tpo dung thdi han dupe phdp.
4.Niu bj bupc thdi hpc sS bii hoan kinh phi theo qui djnh ciia Nha nude. Neu phai gia h^n thdi gian hpc tap sS ty tuc kinh phi trong thdi gian gia hpn.
5.Sau khi kit thtic khoa hpc vi nude, thyc hi$n thu tyc bao cao tit nghiip cho B6 Gi4o dye v4 Dao tyo va lam vi^c lau d4i theo sy diiu dpng cua Nh4 nude.
6.Cam kit niu trdng tuyin hpc bong cdacip sS di hpc theo dung ki hoych doySu ciu.
Tdi xin cam- kit thyc hipn diy du nhttng diiu neu tren va cic quy djnh hifn hanh khac cd Hen quan. Niu khong thyc hipn dung ban cam kit nay, tdi xin boi hoan loan bp chi phi d4o tyo va hoan toan chju tr^ch nhipm vi vipc xu ly ky luat theo cic quy djnh hipn hanh cua Nha nude.
...jng4y....thang....n&n ...
Ngudi cam kit (k^ va ghi ro ho tin)
Mau3b
CONG HOA XA HQICH^ NGHlA VIET NAM
Doc lap - Tu- do - Hanh phiic
BANCAMKET
THyC HIEN NGHIA V\J CUA LU*U HQC SINH
(danh cho ngucri chua CO co quart cong tac) Kinh giii: Bo Giao dye v4 Bao tyo
^... ^., ngaythingnan .
B6 (m?)
{kj> va ghi ro hg tin)
CAM KlLT CUA GIA BINH
H<jvktenb6(m?): „,„....,^,.^...I..^..^,...,.^..
Cong tic t^:^...aa...,..>.,>..a,^.i^.,tJ;....^..,..,...„
Pjachi; ...„..^„...:,. ^.^i^,.,.,.,,,.,,^...,,,,, ...„ : :•• ,:;: • • • : .i:^
d?i di^n cho gia tfinh ltlu hpc sinh C6 t€n tt^n, chiing t8i cam kit: E
-NhSc nhb, dng viSn lvra h</c sinh Hafc hifn d^y di nghia v^i dS dut^tc quy dinh doi v6i lira hgc sinh.!;
-Cung liru h^c sinh b6i hoan kinh phi d3 dupe Nh^ nude cip niu luu hpc sinh khdng th^c hi^n dung cam kit.
X4c nh^n ciia eff quan BHXH (xdc nhSn din thing ddng d^ tiin BHXH).
CO QUAN BHXH:...„.„„.
Xdc nh^n Ong (B4):...
Hi^n dang tham gia BHXHtil thing nto ... din thing... nSm ...
thco co quan cdng tie:^,...^.,.
Si si BHXH:,^..,..„...
, ngay thing nSm 2021
giambOcbhxh
Xac nh^in cua don vj:Ngirfrid^nghj
(Kytin,dongddu)(Kyrdh^tenJ
Tta tdi 14:.-.,...CMND s6: ...
Chile danh:...,
Hin dang 14m vic t^u:„^....„.
D6ng BHXH t^i BHXH:„,,.,.
B^ nghj don vj xlc nhfln cho t6i dang tham gia BHXH t^u don vj.
L^ do xdc nhjm:....,,...„
Kinh gui:(Thu taring don vj ngirM lao d?ng dang lam vi|c)..
Mau 4
CONG HOA XA HQICHU NGHIA Vl^T NAM
Doc lap - Ty do - Hanh phuc
„...,, ngay thing nOm 2021
GIAYXACNHAN
6)Dantpc:, 7)T6ngiao:
8)Noi dang k$ b khSu thuimg trfc~
(S6 nha, duimg ph6, thanh ph6, x6m, thon, xa, huyen, tinh) 9)Noi d hi$n nay:,
(S6 nha, dutag pho, thanh ph6, xom, thdn, xa, huy^n, tinh)
10)Ngh6 nghi^p khi du^c tuyen dpng:
11)Ngay tuy^n dung: ...I...ICo quan tuyen dung:„..
12)Chiicv^(chiicdanh)hi^ntai: .,, (Ve chinh quySn ho^c Ding, do^n thi, kk ck ch^rc v^ ki6m nhiem)
13)C8ng vi^c chfnh du^o giao: .,„...
14)Ngach cong chuc (vi6n chiio):M^ngach:
BScluong:He so:..., Ng^yhudng:.../..,/
Ph^ dp chic vp:... Php dip khic:...
15.1-Trinh d^ gj^o dye ph6 thdng (da tOtnghifp lop may/thu$c h^ nSo):.,
15.2-Trinh d^ chuyen m6n cao nhfit:„...,.„.„..,....
(TSKH, TS, ThS, c^ nhfin, k^ su, cao dang, trung cap, so cdp, chuy^n nganh) 15.3-L^ Iu^n chlnh trj:15.4-Quan 1^ nha nuoc:„
(Cao cap, trung cap, so dp v^ tuong duong) (chuyen vien cao cap, ehuySn viSn chinh, chuySn vi^^n, cdn sy,) 15.5-Ngo?i ngtt:15.6-Tinhpc:
(Tgn ngo^i ngtt + Trinh d A, B, C, D) (Trinh dp A, B, C)
16)Ng4y vao Ding Cong sin Vi^t Nam:.../..7... Ngy chinh thiic:...A../....,.
17)Ng^y tham gia t6 chile chinh trj - xa hph^^.•- (Ngay tham gia t6 chiic: 0oan, Hi... va lam vi^c gi trong t6 chiro d6)
18)Ngay nh^p ngu:.../.../..., Ngay xdt ngii:..,/.../..., Qu^n ham cao nhit:,..., 19)Danh hieu dupe phong tang cao nhlt„...,....„
SO YEU LY LICH CAN BO, CONG CHUC
1)Hp vk tSn khai sinh (viet chtt in hoa):
2)Ten gpj kMc: ....„.
3)Sinh ngay:... thang ... n^m ... Gi<W tinh (nam, nO):^
4)Noi sinh: Xa...Huyen Tinh
5)Qu6 qu4n: Xa, HuynTinh...
Anhmau
(4x6 cm)
Co quan, don vi c6 thlm quySn quan ^^ CBCC . Co quan, don vj sir dyng CBCC
Mau 2C-BNV/2008
Chiic danh, chiic vy, dem vj c6ng tic (ding, chinh quyin, doin thi, tfi chuc x3 hgi), kg ci thai gian dupe dao tao, bdi duong v
chuygn m6n, nghigp vu, Tfr thing, nim dgn
thing, nim
Ohi chu: Hinh thuc dio tao: Chinh quy, tai chtic, chuygn tu, b6i dudng..../ Van bang:
TSKH, TS, Ths, CCr nhta', Ky su' 28) T6m tat qui trinh c6ng tic
Vin bang, chting chi,
trinh df gi
Hinh thuc diotao
.../-.../
.../-.../
.J-.../
.../-.../
.../-.../
.../-.../
.../-.../
.../-.../
Tir thing, n5m - den thing, nim Chuygn nganh dtto
t^o, b^i duong Ten trubng
(Anh hung lao dpng, anh hung lire lupng vu trang; nhi giio, thiy thuoc, nghe si nhan
dan vauu tu, ...)
20) S6 truong cong tic:
21)Khenthudmg:22)K^lu^t:
(Hinh thuc cao nhit, n3m nao)(vg dang, chinh quyin, doan thg hinh thi3rc cao nhat, nim nao)
23)Tinh trang siic khoi:Chigucao:..., Canning:....kg, NhOramau:
24)Li thucmg binh h^ng: ...J., Lit con gia dinh chinh sich:
(Con thucmg binh, con lift st, nguW nhilm chit dfc da cam Dioxin)
25)S6 chting minh nh^n d^n: 4Ngay cip: .../.../
26)So s6 BHXH:
27)0^o t?o, bdi dudng vg chuyen mon, nghifp vu, ly luan chinh trj, ngo^i ngft, tin hpc
Qu^ qudn, nghi nghi^ p, chdc danh, chtirc vu, do^i vi cong tac, h^c tap, noi d (trong, ngoai nude); thanh vien cac t6 chdc chinh
trj-xSh^i,,) Ndm
Hgv^t&i sinh
M6i
quanhf
30) Quan h gia dinh
a) V8 ban thSn: Cha, Me, V<^ (ho^c chdng), ede con, anh chj em ruOt
- Co than nhSn (Cha, M?, Vgr, Ch6ng, con, anh chj em ru^t) b nude ngoM (l^m gi, dja chi)?
- Tham gia ho^c c6 quan h vdi cdc t6 chuc chinh trj, kinh ti, x3 h^i n^o b nude ngoiii (litm gi, t6 chiic nao, d^t try set b dau?):
29) BSc Him ljch sd ban thSn:
- Khai ro: bi bit, bj tu (tit ngay thang n5m ndo den ngay thdng n5m ndo, 6 dSu), da khai bdo cho ai, nhung van d^ gi? Ban than co lam vi^c trong chi d cu (ca quan, don vj nao, dja di&n, chiic danh, chiic v^, thai gian lta vifc ....)
Ngaythdngd^2021
Thu trudng caquan, don vi qudn ly va sir dnng CBCCVC
(Ky ten, dong ddu) Ngu^^i khai
T6i xin cam doan nhting 1W khai trSn dly I^ diing sg th|t
(K^ ten, ghi r8 hp ten)
32) Nhan xlt, dlnh gil cila ca quan, dan vj quln 1^ vi sur dpng cln b0, c6ng chiic H| s6 lucrng
M5 ngach/bac Thang/nSm
31) Diln biin qu^ trinh luang cua cln b6, cong chiic
Qu6 qu^n, nghe nghiep, chiic danh, cMrc vu, dan vi c6ng t^c, hpc tip, nai a (trong, ngo^ nude); thanh vien clc t6 chiic chinh
tri - xa hpi) Nam
Hp va ten sinh
Moi
quanhe
a) Wh bSn vg (hope chong): Cha, Me, anh chj em ru^t
S6 hi$u:^, Kyhieu:....
Chimg minh thu nhan din so:Ncri cSp:.
Ngaythang..,.n5ra
S6Difn tho^i H6n h|: Nh4 rifing...
Khi cln bio tin cho ai? 6 d^u?:
Hpvat^r....„.,.,.. Nam, nS:
Sinhng^yth^ng...-.-...nSm
Noi d ding Iq? hO khiu thutag tru hifn nay:^
TlTTHUAT
SOYEULYLICH
lich)
xac nh?n \f cua cc quan giap lai cua (c6 d6ng dlu
4x6cm AnhmSu
CONG HOA XA H0I CHfi NGHIA VI$T NAM
89c lap - Tu- do - Hanh phuc
Mill 5
Tit nam 1955 dn nay l^ra gi? 6 dSu? (Ghi r8 ten ca quan, xf nghi^p hipn nay dang lam) Trong khdng chiin ch6ng thyrc dSn Ph4p lam gi? 6 d^u? .
Nghd nghi^p Hp va t&i b6:Tu6i
Trade c4ch mpng Th^ng 8 lam gi? 0 dSu? „..
Tlianh phin ban than hi^n nay:~
Trinh dp v8n hod:Ngopingft:
Trinh d chuy&i mdn: Lopi hinh d4o tao ChuySn nganh dao tao:
KSt npp Bang cng s4n Vi^t Nam ng4yth^ng...n3m
Naik^tnpp:
Ngay vao Boan TNCSHCM ngaythdngn8m:
Noiketnpp:~
Tinh hinh s6c khod:Can lmC^nngng:kg
NghS nghi$p ho^c trinh d chuydn m6n:
C^pb?c:Luang chlnh hipn nay:
Ngaynh$pngu:Ngayxuitngfl:„
Ly do:„
ho An cAnh gia binh
Dantpc:...Tongido:,„..,
Thanh phin gia dinh sau cai cdch rung ddt (ho|c cii tpo cdng thuang nghipp).
Nai d3ng V^ thuimg trii hidn nay: .
Hp vdten:Bi danh:..
T6n thuimg gpi:
Sinhngaythangn5raTai:
Nguyen quan:,
_3
HQ VA TfeN ANH CHJ EM RU0T
(Ghi ro ten, tudi, did &, nghi nghiip vd trinh it^ chinh trf cua tieng ngirdi) Trong ktang chi^n ch6ng th^c dSn P^p lam gl? d dau?
Tit n^m 1955 d^n nay lam gi? (3 dSu? (Ghi rS tSn co quan, xf nghifp hien nay dang lam) Hpvatenm?:Tu6i:....Ngh^nghiep
Trade each mang Thang 8 lam gi? (3 du?
....,ngayth&ngnam..
Nguoi khai ky ten Xic nhan cua Thii trirdug Ca quan,
Xi nghi^p, Chu t|ch UBND Xa, Phirfrng
LOICAMBOAN
Toi xin cam doan nhftng lcri khai tr6n li dting si? th^c va chiu trich nhi^m ve nhftng loi khai d6. N6u sau niy ca quan cd thim quy^n phit hifn vdn dS gi khong dftng. Toi xin chap hanh bi?n phap xflr 1^ theo quy djnh./.
Gift chuc v\i gi?
VA KY LUAT
CidSu?
KHEN THlTOfNG
Lam c6ng tic gi?
Khenthuong: ....
KyluSt:
Ttr thang nSm den thang n^m
QUA TRINH HO4,T BQNG CXIA BAN THAN
Hq va ten vp hoac chong:...Tuoi:
Nghenghi^p:
Noilikn viec:
ChS a hien nay:
Hp va ten cac con:
1)Tu6i:NghS nghiep:
2)Tuoi:Nghe nghiep:
3).Tuoi:Ngh nghiep:
4)Tu6i: ...„Ngh^ nghiep:
5)Tu6i:Ngh^ nghiep:
I.TlNH TRANG THE LVC (0>H3IMECK0E COCTOHHHE; ETAT GENERAL)
Chi^u cao (Pocr; Hauter).„^...,.(cm: cm) Ctn ning(Bec;Poidj).->.„.._...,... ..(KG kg) Ving ngirc (OKpy^tHOCTt rpy^n; Pirimetre thoracique)(cm; cm) Th^^ra(BMAox; En expiration)...,(cm; cm) Hit vio(Box; En inspiration).(cm; cm) Trung binh (CpcAHan; Pignet moyen).^,(cm; cm)
BAcs^ khim (Bpaa; Examinateur) II.BfNH TAT (3AEOJIEBAHHSI; MALADIES)
I. NOI KHOA (TEPAnEBT; MALADIES INTERNES) -Tuln hoin mgch(nyabc; Appareil cardiovasculaire)...
lln /phut (Ynap/MNH; Pouls/min) -Huylt ip (ApxepHabHoenanneHHe; Tension artirielle )
T8i tfa(Max; Systolique)(MM/pr.croab; mm/Hg) T6i thi^u ^Mhh; Diastolique)( MM/pT.crojib; mm/Hg) -Tim (Cepnne; Coeur)...,.,..,,...,...,....
-Ph8i (JlerKne; Poumom),.
Bics? khim (Bpau; Examinateur)
H^ vi tinNgiy, thing, niro sinh Nghi nghi^p....Nam, nth.
Ccrquan—
Ch8*.
CONSEIL MEDICAL
GIAY CHtfNG NH^N StTC KHOE meahii:hhckah ciipabka
certificat medical
Ll^N BO GIAO DVH^i6NG GUAM BINH Y KHOA
BAOTAO-YT" ME^HUHHCKAH KOMHCCHfl
TRU^NG BOAN KHAM K^
r^ABHBrit BPAM nOHFIHCb LE MEDiaN CONSULTANT
SIGNATURE chC tjch hoi d6ng k*
IIPEflCEMTEJIB KOMMHCCHH nOOTHCB VUE ET APPROUVE PAR LE CHEF DU CONSEIL SANITAIRE SIGNATURE
Ngly(flaTa; Date)..thing.nim
MauO6 5. XET NGHI$M HUYEt HOC SINH VAT, SINH HOA BW (JIAEOPATOPHBIE O6CJ1E-
^OBAHHH - TEMOTOJIOrHMECKHE, BHOJIOrHHECKHE BHOXHMHHECKHE BCBC;
EXAMENDUSANG,B1OCHIMIQUEBW, VDRL)
Xquang (X-rpa4>Hn; Radiographic)...
KET LOAN (3AKJHOHEHHE; CONCLUSION) a.TtNH HtNHStfC KHOE (nPAKTHWECKH 3^^OPOB(A); ETAT DE SANTE)
b.Ot HAY KH6NG DO StfC KHOE BE BI HOC (nPAKTHHECKH 3,ROPOB(A) H no COCTOHHHK) MO5KET BBITb HJIH HE M05KET BBITB HAIIPABJIEH(A) HA
LINTERESSEtEJESTAPTE/INAITEAUX ETUDES),...
4. CHUVfeN KHOA (CIlEUHAJItHME 3AEOJIEBAHHfl{ EXAMEN DU MEDEC1N SP^CIALISTS)
-Mil (Tjiasaj Acuit^ visuelle).
Khdng klnh (Be3 0<iK0u; Sans correction)...
Phil (IIpasuR; Droite) O.D.
Trdl (Jleuufl; Cauche) O.C Cd klnh (C OAKaMH; Avec correction)
Phli(IIpasull; Droite) O.O.
Trdi (Jleoul; Gauche) O.G.
Bic s? kh<m (Bpai; Esaminitteur).
-TniM0IH5ng(OroJMpnnroJionORL)..
-Thinh Igt, ndl thtrbng 5nt (Cnyx npn nopM. pemt 5m'; Audtotndtrie i 5m-volx normaie) Tal phii (Ilpasoe yxo; Oreille droite).
Tai trii (Jlenoe yxo; Oreille gauche)...,
N6I thim O^nt (npn luonore 0,5m; Audiomrle 1 0,5m-volx basse) Tai phit (npauoe yxo; Oreille droite).
Tai trdi (Jle&oe yxo; Oreille gauche)...,
- Bfnh V^T.M.H (3a6ajieuanHe yxa, ropju,Hoea; Maladies ORL),.
Bdcs^ khdm (Bpas; Exantinateur).
-Rflnghhm m^t (CroMa-ronor; Dent)...,.,,..,.,...„
B*c sf khim (Bpa<t; Examinateur) -Phg khoa(THHeKOAOr; Maladies gymdcologiques),
Bicsf Ididm (Span; Examinateur).
-Daliiu (^epMaTOJior; Maladies dermatovdndrologiques).
Bdc sj khim (Span; Examinateur).
-DfdhypKeayAOisl'estouiac)., Bit ay kh<m (Bpau; Examinateur).
1. TAM THAN, THAN KINH (DCHXHATP, HEBPOnATOJIOI"; NEURO-PSYCHIATRES)
Biesf khlm (Bpan; Examlnateur),
3. NGOAIKHOA (XMlWr; MALADIES CHIRURCICALES).
>Dimi (Onepaun;Inteventlonchirurgicale)....,..., -ThMgian (flam; Date)....„...,..
-HJ vf n d?ng, e$t sing (Onopno-jtoHnrrejiMtan cHCTMa, cnHHHOil xpe6eTi Colonne rertebrale, appareil-locoinoteur^... „,,....,.,.
-Chi tr8n(BepxHneitOHenHocni; Membres auptrleorea).,_
-Chi dir^ (HmSHHe kohchhocth; Metnbres intdrienra).,...,...
-Khtfp (Cycmsw; Articulation).„„...,....,„...,..^^
-Xrong(K0Crtl;O).,,„,...,„
-Cff (MycicyAxiypa; Muscles)....,....,..,...,.,.,...,.,...,...,.,,...„..„,..
-Tim mgch^CepAesHU^ocyAHctaflcHcyeMaiCardiovasculaire)...,,...,,,...,...,..,..,,,....
-H|um8n(AHyc;Auua)....,._
• Ti^t ni^u,sinh dgc(BbuieairreASHue h noaosue opraHu^ Appareii urfr^dnital)..,.
-Khilu(OnyxoAH;Tumeurs)...
Bfa sj kbdm (Bpas; Eaaminateur).,
m
Abdomen Tonsils
E^
Lymph nodes
as Eyes
5$fflf
Neck
AH S^^tt
Blood pressure mmHg
Lungs Nose Skin
.
HEaa *
L Corrected vision ;f(P NourishmentWeight Kg
Heart
n
Ears Colour sense
*R a*
Vision
AfttIWi
Development
ftft B^
Height CM
ft5#&TJ!l^^X^^#ft)*jfii^:fe*: (ft^^SBfllf^^ "5" IE "ft" )
Do you have any of the following diseases or disorders endangering the public order and security?
(Each item must be answered "Yes" or "No")
ft^^ft Toxicomania—DNo DYes ftttftS. Mental confusionDNo DYes ft^^ll Psychosis: SHM Manic psychosis-"DNo DYes 5gfflS Paranoid psychosis'-DNo DYes IQM.^ HallucinatoryDNo DYes St*ftSJ&WT^I: (*SJBH1t@* "" sE "ft")
Have you ever had any of the following diseases?
(Each item must be answered "Yes" or "No")
38* ^^ Typhus fever DNo DYes If ^J Bacillaty dysentery DNo DYes '•WU^^fi Poliomyelitis DNo DYes ^Kff^^^ Brucellosis DNo DYes 6 P8 Diphtheria DNo DYes ft^^ttffifc Viral hepatitis DNo DYes B SI jHt Scarlet fever DNo DYes j^^ISjfflffi^f Puerperal streptococcus infection
^j jB ^) Relapsing fever DNo DYes ft ^^ jfe DNo DYes ffiSsfW+ft* TYphoid and paratyphoid fever DNo DYes
ittTf4B^IB!li^^ Epidemic cerebrospinal meningitis DNo DYes
MX Um*ia^ftfp^)
Photo (Stamped Official
Stamp)
Jfilfi
Blood type
th^feis
Birth place
a^H
Birthday D BMale
D -jc. Female
tt*J
Sex
Nationality (or Area)
Present mailing address Name
FOREIGNER PHYSICAL EXAMINATION FORM
:.':;.i.:.-.':::t-: ••" ' •:::.;:. '•."'- •V^M \ .' ''''. "• '•'"• : : •;;i:v"':- ..r::::V:;::;:;::::;: :::; i: i: r • •-: patg. .;. • :::;;.::. .; :i ::::;: ": :.;:..
:.:.:;T^I;;.-;. ^ ::;- r••; af#^^ ^: ..'.." , •: :: :
•' .; :-:;^:!; ::...:::: r : .••^.: . Official Stamp ::,.-:•:. ' ' :Leprosy: ;r;;::-•r.r;:':; • ^#^ ^psychosie : •• "'i^; ":i^ :
Plague :;,,•: ttm^. aids ,:;:.... .V,::,; : 5 Yellow fever #gi^ ^ung tuberculosis ;:
^Cholera •-.••-•• tt^! Venerl Disease I
EI^B^ •";i::i::;^;^! :i •:;
Signature of physician ^
^ 3ft • 1^ !=•:-!:"!:=;,^?."=-"""
Suggestion ^,:::
:::-:.:;-...:,V,::::-:r::H
^ sa
None ofthe following diseases of disorders found during the present examination.
BCC
Nervous system Extremities
AIDS, Syphilis etc) (attached test report of
(fflv
^#^*^^)
Laboratory exam report)
s.
(attached chest X-ray Chest X-ray exam
*^^x ^ Qt&er abnormal findings
Spine
