ࡱ> #` Rcbjbjmm2n"XXXX***88*\*O=|+|++++5-5-5-<<<<<<<$?heB<E8/-"5-8/8/<XX++ =6668/TX8++<68/<667&8+p+ LTX*388 =0O=8C4C&8C&8l5-v-T6-DC.5-5-5-<<5^5-5-5-O=8/8/8/8/D%**XXXXXX  IBM Visiting Scholars Program Application Form Please complete the formexcept appendix I and II) in English I. General Information Name(Chinese) (Pinyin)_____________ Gender__________ Birthday(yy/mm/dd) Single/Married__________ Title of technical post Title__________________ Years of service in university_________________ University name _____________________________________________ Department name________________________________________________ Graduate university ____________________________________ University degree(ph.d, master)________________ University major ______________ Mail address__________________________________________________ Postcode Telephone( )- Fax___________ Cellphone____________ Email____________________________ II. General Visiting Plan Planned visiting date: from to_______________ Research directions Research plan Target research achievement III. Education status University nametimemajorUniversity degree and certificates IV. Foreign Language Level English__________(excellent, good, average, poor or indicate the certificate you have) Japanese__________(excellent, good, average, poor or indicate the certificate you have) Others__________(excellent, good, average, poor or indicate the certificate you have) V. Study and working experience outside China Country and institution/university nameStudy/working timeAny sponsor? From whom?Study/working directionsWorking language VI. Research experience in the past 5 years Research directionstimeMajor job roleResearch achievement VII. Present working and research status VIII. List the patent you owned, your major research achievement, and research/working award, etc. IX. List your thesis, books published in the past 5 years. (please send the softcopy of your thesis in your email) X. The use of IBM Technology. Any certificates of IBM? XI. Research plan after visiting XII. Please list 2 contact person in your department for reference NametitletelephonecellphoneemailNotice All the forms should be completed and submitted to IBM University Relations before July 3rd, 2009. Use an attachment for any certificate, thesis or personal photo. 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