高等学校青年骨干教师国内访问学者

研 修 工 作 计 划 表

姓名  XXXX  性别   男 出生年月 19XX.XX

学历 XXX  学位 硕士 专业技术职务副教授

推荐学校及院系 XXXXXX计算机学院  

访问院系（所）及专业   XXXX大学         

信息科学与工程学院  计算机应用技术      

指导教师           XXXXXXXXX          教授

计划研究课题XXXXXXXXXXXXXXXXXXXXXXX分析研究

访问时间  20##   年 9月至2015  年 7月

邮编及通讯地址XXXXXXXXXXXXXXXXXXXXXXXXXXXXX

电话  XXXXXXXXXXXXE-mail  XXXXXXXXXXXXX  

_

教育部高等学校师资培训交流武汉中心制

注：1.此表由访问学者入学报到后，与导师协商后填写。

2.此表一式五份，访问学者一份，指导教师一份，师资培训管理部门三份（报到后两周之内交，其中，一份存档，一份寄至教育部高等学校师资培训交流武汉中心，一份待结业后连同中期考核表和结业考核表一并寄给推荐学校师资管理部门）。

3.访问学者在导师指导下，应以科研为主，切实按照此工作学习计划去实施，确保按时完成预定课题研究工作；无法完成访问计划的，将被作为一般科研进修对待。

第二篇：访问学者申请表(含研修计划表)

The

GRADUATE SCHOOL

of

ARTS AND SCIENCESHARVARD

UNIVERSITY

Visiting Fellow Application

Academic year for which you are applying: _____________________ ??Full academic year

??Fall term only

??Spring term only

Please submit this application with the $70 application fee. Acceptable forms of payment include: any domestic (US) check or moneyorder made payable to Harvard University; foreign checks or money orders if drawn against a corresponding US bank; any Canadiancheck or money order if drawn in US dollars; Japanese postal money orders. The application fee is not refundable.TYPE OR PRINT LEGIBLY.

1.Full legal name: ______________________________________________________________________________________________________

(Use no initials. Circle your family name.)2.If your records have ever been filed under another family name, give that name: ______________________________________________3.Current mailing address:

____________________________________________________________________________________________________________________________________________________________________________________________________________________Good until: ___________________________________________4.E-mail address:________________________________________5.Telephone numbers:

Day:_________________________________________________Night: _______________________________________________6.Permanent mailing address:

____________________________________________________________________________________________________________________________________________________________________________________________________________________Telephone number: ____________________________________

13.Will you apply for a Harvard-sponsored visa?

____ yes____ no14.How did you learn about visiting fellow status?

________________________________________________________________________________________________________________________________________________________________________________________________________________________10.City and country of birth: _______________________________11.Citizenship: ___________________________________________12.Permanent US resident: ____ yes____ no7.Gender:_____ Male

_____ Female

8.Birthdate: _____________________________________________

monthdayyear9.Social Security # (US citizens): ___________________________

Have you applied before as a GSAS visiting fellow or special student? ____yes ____no

If yes, when?

________________

Accepted?

____yes____no

Attended? ____yes ____no

Have you ever applied to any GSAS degree program? ____yes____no

If yes, when? ________Which department? ___________________Admitted? _____yes ___no

Attended? ____yes ___no

Other current or former Harvard affiliation:__________________________________________________________________________________PROGRAM OF STUDY:

Choose one: departmental affiliation____ general studies____

If your preference is to be affiliated with a department, which department/s? (For a list of departments, go to www.gsas.harvard.

edu/u_departments/index.html.)________________________________________________________________________________________________________________________________________________________________________________________________________________List any Harvard professors you have contacted either in person or by mail:

________________________________________________________________________________________________________________________Indicate any grants or other funding expected:_______________________________________________________________________________________________________________________________________________________________________________________________________Name of person recommending you (indicate position/title and institution):______________________________________________________________________________________________________________________________________________________________________________

EDUCATION—List post-secondary academic institutions, degrees received, and dates:

College/University

Location

Years attended From To

Field of Concentration

Degree

(Received or Expected)

Type Date

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

EMPLOYMENT HISTORY—In reverse chronological order, list professional positions held with institutional names, locations, and dates:(You may also include your curriculum vitae.)

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

ARTICLES AND/OR BOOKS PUBLISHED; INVENTIONS PATENTED; OTHER RESEARCH OR CREATIVE WORK.(One or two copies of suchwork may be submitted, if desired.)

_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

SUMMARY OF RESEARCH PLANS:Summarize in paragraph form your research proposal, indicating specific subjects, research objectives,possible timetable, library collections and other resources needed, and individual faculty members you hope to consult. If possible,include titles of any courses you may hope to audit. (If more space is necessary, you may continue on the reverse side and attach nomore than three additional sheets.)

I certify that the information provided on this application is accurate, complete, and honestly presented. I understand that any inaccurateor misleading information or omission will be cause for disqualification from further consideration for admission and will be cause for therescinding of any offer of admission, or for dismissal from the visiting fellow status if discovered at a later date. I further acknowledge thatI have read the visiting fellow information provided with this application, and that I understand that I am applying for neither degree sta-tus, nor a faculty appointment.

SIGNATURE:____________________________________________________________DATE:_________________________________________Please return all application materials to the Special Students/Visiting Fellows Office, Byerly Hall, 2nd Floor, 8 Garden St., Cambridge, MA 02138.

Additional space for summary of research plans.

Special Students/Visiting Fellows Office

Graduate School of Arts and Sciences

Harvard University

Byerly Hall, 2nd Floor, 8 Garden Street, Cambridge, MA 02138phone: 617-495-5392 ?fax: 617-496-5333 ?e-mail: special@fas.harvard.edu

Web: www.gsas.harvard.edu/programs/nondegree/index.html