專業(yè)技術(shù)職務(wù)申請(qǐng)表

1、專業(yè)技術(shù)職務(wù)申請(qǐng)表（青年杰出人才申請(qǐng)正高級(jí)專業(yè)技術(shù)職務(wù)評(píng)聘專用）App lication Form for Position of Professor or Equivalent Position, SYSU OutstandingYoung Faculty Use Only編號(hào)No.:二、學(xué)習(xí)經(jīng)歷（大學(xué)及以上，含海外進(jìn)修經(jīng)歷）Educational Background（Bachelor degree and above, overseas study in eluded）起止年 月Date學(xué)校名稱Schools/lnstitutions Attended（海外高校請(qǐng)注明所在國(guó)家）（Coun

2、try Should be Stated）學(xué)歷/學(xué)位Degree Obtained專業(yè)Major自 From至To三、工作經(jīng)歷 Empioyment History起止年 月Date工作單位 /機(jī)構(gòu)Schools/ Institutions of Employment職務(wù) Position Held自 From至To四、學(xué)術(shù)榮譽(yù)及社會(huì)兼職 Academic Honors & Social Services榮譽(yù)/社會(huì)兼職Title of Honors/ Services獲得/受聘日期Date Obtained頒授/兼職機(jī)構(gòu)Issued/Em plo yed By五、教學(xué)工作(任現(xiàn)職近五年內(nèi))(可

3、另附頁(yè)) Teaching Experience(most recent 5 years; ifcurre nt p ositi on is shorter tha n 5 years, p lease list the exp erie nces since the p ositi on started; if n eeded, attach a sheet.)1 .課程教學(xué)情況(學(xué)年學(xué)期至學(xué)年學(xué)期)Courses Taught From the (1 st/2nd ) Semester(Year) to(1st/2nd ) Semester(Year)開(kāi)課 學(xué)年 學(xué)期Semester an

4、d Year教學(xué)課程 名稱Course Title課程屬性Course Type (Com pu lsory/Selective)學(xué) 分Credit學(xué) 時(shí)CreditHour授課對(duì)象及 人數(shù)Targeted Student and Number of Enrollment實(shí)際擔(dān)任 課堂教學(xué) 學(xué)時(shí)數(shù)Actual Credit Hour for Classroom Teaching課程 系數(shù)CourseCoefficient工作 量AmountofTeachingLoadhing Full-tiiie Undergraduate:總計(jì)學(xué)時(shí)數(shù)Total Credit HoursTeac類別Typeh

5、ing Graduates總計(jì)學(xué)時(shí)數(shù)Total Credit HoursTeac2.指導(dǎo)學(xué)生情況 Students Sup ervised學(xué)生類別Stude nt Type時(shí)間Period（年 月一年 月）學(xué)生數(shù)(專業(yè)、年級(jí)、姓名)Student List (major, year in pr ogram, name)折合學(xué)時(shí)數(shù)Equivalent Credit Hours指導(dǎo)博士生 Ph.D Candidates指導(dǎo)碩士生Master Degree Candidates指導(dǎo)普普 業(yè)全 論日 文制本科生畢 TheSupfervisnneGiMon其他Others總計(jì)學(xué)時(shí)數(shù) Total Cred

6、it Hours3. 審核意見(jiàn) Verification(1)對(duì)校本部申請(qǐng)者的審核意見(jiàn)承擔(dān)普通全日制本科教學(xué)工作量合計(jì) 學(xué)時(shí)，年平均教學(xué)工作量 學(xué)時(shí)。其中，課程教學(xué)共_學(xué)時(shí)，指導(dǎo)畢業(yè)論文工作量_學(xué)時(shí)，本科生教育教學(xué)其他工作折合工作量學(xué)時(shí)。Verification for App licants from the Main Campu sesFor Full-time Undergraduate Teaching :Total Credit Hours:Average Annual Credit Hours: Course Teach ing Hours: Thesis Supervision

7、Hours: Other Equivale nt Credit Hours: 院系審核人簽字 Reviewed by :年 月 日Y/M/D 承擔(dān)研究生教學(xué)工作量合計(jì)學(xué)時(shí)，年平均 教學(xué)工作量 學(xué)時(shí)。其中，研究生課程教學(xué)共學(xué)時(shí)，指導(dǎo)研究生折合學(xué)時(shí)。For Graduate Teach ing :Total Credit Hours: 本科教學(xué)主管部門(mén)審核意見(jiàn)： Verification by the Dep artme nt in Charge ofUn dergraduateTeach ing:經(jīng)核實(shí)，普通全日制本科生課程教學(xué)工作量 學(xué)時(shí)。For Full-time Undergraduate

8、 Teaching :Total Credit Hours:審核人簽字 Reviewed by : 單位(公章)Official Seal :年 月 日Y/M/D研究生教學(xué)主管部門(mén)審核意見(jiàn)the Dep artme nt in ChargeTeach ing:經(jīng)核實(shí)，研究生課程教學(xué)工作量 導(dǎo)博士研究生名、碩士研究生Verificatio n byof Graduate學(xué)時(shí)，指名。Average Annual Credit Hours:Course Teach ing Hours:Thesis Sup ervisi on Hours:院系審核人簽字 Reviewed by :年 月 日Y/M/D

9、For Graduate Teach ing：Course Teach ing Hours:Total nu mber of sup ervised Ph.D can didates : Total number of supervised Master Degree can didates : .審核人簽字 Reviewed by : 單位(公章)Official Seal :年 月 日Y/M/D8分。,the total(2)對(duì)附屬醫(yī)院申請(qǐng)者的審核意見(jiàn) Verification for Applicants from the Affiliated Hospital 經(jīng)核實(shí)，教學(xué)工作量分，教

10、學(xué)質(zhì)量評(píng)價(jià)分，教學(xué)總分By verificati on, the score for teach ing load is , the score for teachi ng quality is score is .教學(xué)管理部門(mén)審核人簽字 Reviewed by(from the Dep artme nt in Charge of Teachi ng):單位(公章)Official Seal :年 月 日Y/M有/無(wú)教學(xué)工作違紀(jì)記錄。(3)本科教學(xué)主管部門(mén)審核意見(jiàn)Verification by the Department in Charge of Undergraduate Teaching

11、經(jīng)核實(shí)，在入校工作以來(lái)如有，請(qǐng)寫(xiě)明時(shí)間及處理結(jié)果：By verification, Dr. (NAME) hasn any/ has some record(s) of violating teaching discipline sincehe/she bega n to work at SYSU; if has, pl ease list the date and results below:年 月 日Y/M審核人簽字 Reviewed by : 單位（公章） Official Seal :六、研究工作(任現(xiàn)職近五年內(nèi))(可另附頁(yè))Research (most recent 5 years;

12、 if current position is shorter than 5 years, please list your research since the position started.; if n eeded, attach a sheet.)1申請(qǐng)人學(xué)術(shù)陳述 Research Statement（請(qǐng)陳述個(gè)人學(xué)術(shù)發(fā)展目標(biāo)、5年學(xué)術(shù)計(jì)劃、當(dāng)前工作中可望取得突破的課題，以及三者之間的關(guān)聯(lián)性） (State the applicant aim s of academic development, plans for the next five years, difficult rese

13、arch problems may be solved and the relation among the above three asp ects.)2.代表性論著Rep resentative Publications序 號(hào)#按全部作者排序(注明學(xué)生、通訊作者、共同第一作者、共同 通訊作者)、論文題目、刊物名稱、出版日期、卷號(hào)、期號(hào)、 起止頁(yè)碼列出List of Author(s) (please indicate whether the publication is co-authored with your sup ervised students, whether you are

14、the corres po ndence-author,or whether authors share equal authorship). Article Title , Journal Title, Year of Publication, Volume #, Issue #, P ages刊物類別Jour nal Category收錄、引 用或轉(zhuǎn) 載 情況No. ofCitati ons12345678910序 號(hào)#著作/教材名稱Title of PublishedBook(s)全部作者排序List of Author(s)出版單位P ublished by出版時(shí)間Year ofP u

15、blicati on著作 總字?jǐn)?shù)Total WordCou nt本人撰 寫(xiě)字?jǐn)?shù)P erce ntage ofPersonalCon tributi on12345文科填寫(xiě) Humanities and Social SciencesSSCI、SCI影響因 子前1%刊物論文(第一或通訊作者，作者 單位為中山大學(xué))SSCI, SCI journals with top 1%IF ( first-author or corres ponden ce-author paper, author work in stituti on should be SYSU)國(guó)際頂尖A類學(xué) 術(shù)期刊論文(第一 或通訊作

16、者)International top-A academic journals (first-author or corres ponden ce-author pap er)所屬一級(jí)學(xué)科(及交叉學(xué)科) 公認(rèn)的權(quán)威期刊論文(第一或通訊作者)P ublic-recognized authority journals in the first-level disc ip line or inter-disc ip lines of the field ( first-author or corres ponden ce-author pape)著作/教材：獲得教育部高 等學(xué)?？茖W(xué)研究?jī)?yōu)秀成果 (人

17、文社會(huì)科學(xué)類)二等 獎(jiǎng)或以上獎(jiǎng)勵(lì)(第一作者， 作者單位為中山大學(xué))Books: Second P rize or higher of Excellent AchievementsAward for Scientific Research in Higher Educational Institutions by the Ministry of Education, China (for Humanities and Social Sciences)( first-author authors work in stituti on should be SYSU)總數(shù) Total作者單位為中山大學(xué)

18、論文 authorworkinstitution is SYSUl理工醫(yī)科填寫(xiě) Science and Engineering， Medical ScienceScience Nature、Cell 等學(xué)術(shù)刊物及其高影 響因子的子刊論文 (第一或通訊作者)Science, Nature, Cell and their sub-journals with high IF (first-author or corres ponden ce-author pap er)本專業(yè)領(lǐng)域權(quán)威 期刊論文(通訊作 者)Authority journals in the field(corres ponden c

19、e-author pap er)所屬一級(jí)學(xué)科(及交叉學(xué)科) 的權(quán)威期刊(即影響因子最高 的1-3種期刊)論文(第一或通 訊作者)Authority journals (one to three kinds of journal with highest IF ) in the first-level disc ip line or inter-disc ip lines of the field(first-author orcorres ponden ce-author pape)收錄為 ESI的Top Paper 論文(第一或通訊作者) Selected as Top Paper of E

20、SI (first-author or corres ponden ce-author pape)總數(shù) Total通訊作者且作者單 位為中山大學(xué)論文corres ponden ce-author and authors work in stitutio n is SYSU總數(shù) Total通訊作者且作者單位 為中山大學(xué)論文corres ponden ce-author and authorwork in stitutio n is SYSU所在單位審核人簽名Reviewed by (from the Department/ School):單位（公章）Official Seal :年 月 日Y/

21、M/D科研部門(mén)審核人簽名Reviewed by (from the Dep artme nt in Charge of Research Adm ini strati on)單位（公章）Official Seal :年 月 日Y/M/D3.承擔(dān)科研項(xiàng)目(不含校內(nèi)項(xiàng)目)Research Grants (university-level grants not included)序 號(hào)#按項(xiàng)目來(lái)源及類型、項(xiàng)目名稱、項(xiàng)目批準(zhǔn)號(hào)、項(xiàng)目全部參加人員(注明主持 人)、起止時(shí)間(注明計(jì)劃完成時(shí)間、實(shí)際完成時(shí)間)、本人承擔(dān)部分列出Source of Funding, Title of the Gran t/ P

22、roject (No.), List of Pr oject Members (pr oject director should be in dicated clearly), Begi nning & Ending Dates (planned ending date and actual ending date should be in dicated), Po rti ons Respon sible.經(jīng)費(fèi) 總數(shù)Grant(RMB)到帳 經(jīng)費(fèi)Amo unt Receive d(RMB)123八、聲明本人謹(jǐn)此聲明以上所有資料及所附證明文件均屬真實(shí)、符合學(xué)術(shù)道德規(guī)范，并可提供有關(guān)身 份及資歷

23、文件的正本以供核實(shí)。本人明白倘若故意虛報(bào)資料或隱瞞重要事實(shí)，中山大學(xué)可取消已 發(fā)出的口頭或書(shū)面聘約，即使已獲聘任亦可被解聘。I hereby declare that the in formati on give n above is true, correct, compi ete and in accorda nee with the academic moral rule. Evide nee about my ide ntity and qualificati ons can be p rovided for verificati on if necessary. I understa

24、nd that any falsification or failure to state the truth will result in cancellation of appoin tme nt eve n if an oral /writte n offer has bee n made, or even if the appoin tme nt has begu n.簽名：Sig nature:日期：Date (Y/M/D):11填表說(shuō)明Notes1. 請(qǐng)用中英文填寫(xiě)， 表格內(nèi)如無(wú)內(nèi)容填寫(xiě)時(shí)要寫(xiě) “無(wú)”。填妥后請(qǐng)用A4紙雙面打印(填表說(shuō)明無(wú)需打印)。Please fill in th

25、e form in both Chinese and English. Please fill out NONE when there is not any appropriate information to be filled in. Please p rint the form (excluding this p age) in A4 paper on both sides.2. 若填寫(xiě)內(nèi)容較多，可插入行、調(diào)整字體大小、表格內(nèi)部寬度，但不得改變頁(yè)面內(nèi)容格式和表格其他結(jié)構(gòu)。若加附頁(yè)，請(qǐng)嚴(yán)格依照本表格式與大小，頁(yè)碼標(biāo)為附X-1、附X-2等(如第五項(xiàng)教學(xué)工作，增加附頁(yè)，頁(yè)碼標(biāo)為附五-1、附五-

26、2 等)。Please adjust the font size and width of the table or add columns to the table if there is not enough sp ace. However, the content and format of each p age should not be changed. The format of attachments should be in accordance with the relevant part of the main form and should be labeled as A

27、TTACHMENT-X-1 (for exam ple, if there is attachment to the fifth part: Teaching Experience, the attachment should be labeled as ATTACHMENT-V-1, ATTACHMENT-V-2, etc.)3.申請(qǐng)學(xué)科：填至二級(jí)學(xué)科；從事專業(yè)：填寫(xiě)專業(yè)名稱；通訊地址：填寫(xiě)可以通過(guò)郵政方式接收信件的實(shí)際地址，建議填寫(xiě)家庭地址。In the first part of the form: Academic Field to App ly should sp ecify the

28、 sub-disci pl ines;Field of Expertise should specify the name of subject;Mailing Addressis supposed to be your home address.4. 第二項(xiàng)學(xué)習(xí)簡(jiǎn)歷：請(qǐng)從大學(xué)開(kāi)始，按自然時(shí)間順序填寫(xiě)，分大學(xué)本科、碩士、博士等階段；第三項(xiàng)工作經(jīng)歷按 不同工作單位/機(jī)構(gòu)任不同職務(wù)經(jīng)歷的順序填寫(xiě)；博士后階段按工作經(jīng)歷填寫(xiě)。Educational Background: bachelor degree and above should be stated in time sequence. Empi

29、o yment History: all empio yers worked for and po sitions held should be stated in chronological order. Postdoctoral exp erience should be stated in this part.5. 第五項(xiàng)教學(xué)工作：課程屬性指公必課(理論 /實(shí)驗(yàn))、公選課(核心通識(shí)/非核心通識(shí))、專必課(理論/實(shí)驗(yàn))、專 選課(理論 /實(shí)驗(yàn))、實(shí)習(xí) /見(jiàn)習(xí)等。Teaching Experience Course Typerefers to Compulsory Courses (theo

30、retical/experimental). Public Selective Courses (core liberal/ non-core liberal), Major Required Courses (theoretical/ex perimental). Major Selective Courses (theoretical (core/non-core)/ex perimental) and Intern, etc.6. 代表性論著請(qǐng)按相應(yīng)要求填寫(xiě)，作者中有本人指導(dǎo)的學(xué)生時(shí)，請(qǐng)?jiān)趯W(xué)生名字處注明；刊物類別，文科按SSCI、SCI影響因子前1%的刊物、國(guó)際頂尖 A類學(xué)術(shù)期刊、在所屬

31、一級(jí)學(xué)科(及交叉學(xué)科)公認(rèn)的權(quán)威期刊填寫(xiě)，理 工醫(yī)科按、Science Nature、Cell等學(xué)術(shù)刊物或其高影響因子的子刊、在所屬一級(jí)學(xué)科(及交叉學(xué)科)的權(quán)威期刊(即影響因子最高的1-3 種期刊)、ESI 的 Top Paper 填寫(xiě)。Representative Publications Please fill in the tableaccording to the requirements. Please indicate the student you supervised if he/she is one of the authors. Journal Category: Appl

32、icants from Humanities & Social Sciences should indicate SSCI, SCI journals with top 1% IF (Influence Factor) , i nternational top-A academic journals,public-recognized authority journals in thefirst-level disc ip line or inter-disc ip lines of the field; App licants from Science and Engineering， Me

33、dical Science should indcate Science, Nature, Cell and their sub-journals with high IF, authority journals (one to three kinds of journal with highest IF ) ,Top Paper of ESI.7. 承擔(dān)科研項(xiàng)目：不含校內(nèi)項(xiàng)目，按項(xiàng)目來(lái)源、項(xiàng)目名稱、項(xiàng)目批準(zhǔn)號(hào)、項(xiàng)目全部參加人員(注明主持人)、起止時(shí)間、本人承擔(dān)部分列出。Research Grants: university-level grants are not included; p l

34、ease list the followinginformation: Source of Funding, Title of the Grant/Project (No.), List of Project Members (p roject director shouldbe indicated clearly ), Beginning & Ending Dates, Portions Resp onsible.8. 主持或參加國(guó)際學(xué)術(shù)會(huì)議情況：個(gè)人角色或貢獻(xiàn)指Chair/Co-chair/ PC Member/ Invited Reviewer/ GuestSpeaker。Chairing/Attending International Academic Conference: Role in the co