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）Application Form for Position of Professor or Equivalent Position, SYSU Outstanding Young Faculty Use Only 編號(hào)No.:申請(qǐng)職位Position to Apply應(yīng)聘學(xué)院（系）School/ Department to Apply申請(qǐng)學(xué)科Academic Fieldto Apply、個(gè)人資料 Personal Information姓名Applicant Name性別Gender出生年月Date of Birth國(guó)籍Natio

2、nality最高學(xué)歷、學(xué)位Highest Degree畢業(yè)院校Degree Institution畢業(yè)時(shí)間Graduation Year現(xiàn)聘單位Current Employer現(xiàn)聘職位Current Academic Title任職年月Starting from （M/Y）從事專業(yè)Field of Expertise研究方向Research Interests身份證號(hào)碼ID No.電子郵件Email通訊地址MailingAddress手機(jī)Mobile 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

3、, overseas study in eluded）起止年月Date學(xué)校名稱Schools/Institutions Attended（海外高校請(qǐng)注明所在國(guó)家）（Country Should be Stated）學(xué)歷/學(xué)位Degree Obtained專業(yè)Major自 From至To、工作經(jīng)歷 Employment 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

4、職Title of Honors/ Services獲得/受聘日期Date Obtained頒授/兼職機(jī)構(gòu)Issued/Employed By五、教學(xué)工作 (任現(xiàn)職近五年內(nèi))(可另附頁(yè)) Teaching Experiencemost rece nt 5 years; ifcurrent position is shorter than 5 years, please list the experiences since the position 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 TaughtFrom

5、the (1 st/2nd )Semester(Year) to(1 st/2nd ) Semester(Year)類別Type開課 學(xué)年 學(xué)期Semester and Year教學(xué)課程 名稱Course Title課程屬性Course Type (Compulsory/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Amo

6、untofTeachingLoadTeachingFull-timie Undergraduates總計(jì)學(xué)時(shí)數(shù)Total Credit HoursTeaching Graduates總計(jì)學(xué)時(shí)數(shù)Total Credit Hours2.指導(dǎo)學(xué)生情況 Students Supervised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 program, name)折合學(xué)時(shí)數(shù)Equivalent Credit HoursPh.D CandidatesMaster Degree Candidates指導(dǎo)普

7、普業(yè)全論日文制本科生畢 TheSisfl亦nergrad職es1其他Others總計(jì)學(xué)時(shí)數(shù) Total Credit Hours3.審核意見 Verification(1)對(duì)校本部申請(qǐng)者的審核意見Verification for Applicants from the Main Campuses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)。For Full-time Undergraduate Teaching :Total Credit Hours:Average Annual Credi

8、t Hours:Course Teach ing Hours:Thesis Supervisi on Hours:Other Equivale nt Credit Hours: 院系審核人簽字Reviewed by :年月曰Y/M/D本科教學(xué)主管部門審核意見： Verification by the Departme 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 Teaching : Total Credit Hours:審核人簽字 Reviewed by :單

9、位(公章)Official Seal :年月曰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:Average Annual Credit Hours:Course Teach ing Hours:Thesis Supervisi on Hours:院系審核人簽字 Reviewed by :年月曰Y/M/D研究生教學(xué)主管部門審核意見Verification bythe Departme nt in Charge ofGraduateTeach in

10、g:經(jīng)核實(shí)，研究生課程教學(xué)工作量學(xué)時(shí)，指導(dǎo)博 士研究生名、碩士研究生 名。For Graduate Teach ing：Course Teach ing Hours:Total nu mber of supervised 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 : 年月曰Y/M/D(2) 對(duì)附屬醫(yī)院申請(qǐng)者的審核意見Verification for Applicants from the Affiliated H

11、ospital經(jīng)核實(shí)，教學(xué)工作量分，教學(xué)質(zhì)量評(píng)價(jià)分，教學(xué)總分分。By verification, the score for teaching load is , the score for teaching quality is , the total score is .教學(xué)管理部門審核人簽字Reviewed by(from the Departme nt in Charge of Teachi ng):單位(公章)Official Seal :年月日Y/M(3)本科教學(xué)主管部門審核意見Verificati on by the Departme nt in Charge of Un der

12、graduate Teach ing經(jīng)核實(shí)，在入校工作以來(lái)有/無(wú)教學(xué)工作違紀(jì)記錄。如有，請(qǐng)寫明時(shí)間及處理結(jié)果：By verificati on, Dr.(NAME) has n'any/ has some record(s) of violati ng teach ing discipli ne since he/shebega n to work at SYSU; if has, please list the date and results below:審核人簽字 Reviewed by :單位(公章)Official Seal :年月日Y/M六、研究工作 (近五年內(nèi))(可另附頁(yè)

13、) Research (most recent 5 years; if needed, 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 'aims of academic development, plans for the next fiveyears, difficultresearch problems may be solved and the relation among the above three a

14、spects.)2.代表性論著 Representative 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 supervised students, whether you are the correspondence-author,or whether authors share equal authorship), A

15、rticle Title , Journal Title, Year of Publication, Volume #, Issue #, Pages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Published by出版時(shí)間Year ofPublicati on著作 總字?jǐn)?shù)Total WordCou nt本人撰 寫字?jǐn)?shù)Perce ntage ofPers onalCon tributi on

16、12345統(tǒng)計(jì)Tote文科填寫 Humanities and Social Sciences rr 1-1 1t » 1t I. . f. 、 SSCI、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 correspondence-author paper，author 'work institution should beSYSU)國(guó)際頂尖A類學(xué) 術(shù)期刊論文(第一 或通訊作者)International top-A academic journals

17、 (first-author or correspondence-author paper)所屬一級(jí); 公認(rèn)的權(quán) 訊作者)journals ir inter-discip or corre總數(shù)Total學(xué)科(及交叉學(xué)科) 威期刊論文(第一或通Public-recognizedauthority 1 the first-level discipline or ines of the field ( first-author spondence-author pape)作者單位為中山大學(xué) 論文 author'work institution is SYSU者件/教材：獲得教育部咼 等學(xué)?？?/p>

18、學(xué)研究?jī)?yōu)秀成果 (人文社會(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 Prize 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, author's work in stituti on should be SYSU)l理

19、工醫(yī)科填寫 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 corresp onden ce-author paper)本專業(yè)領(lǐng)域權(quán)威 期刊論文(通訊作 者)Authority journals in the field (correspondence-author paper)所屬一級(jí)學(xué)科(及交叉學(xué)科) 的權(quán)威期刊(即

20、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 discipline or inter-disciplines of the field(first-author orcorresp onden ce-author pape)收錄為 ESI的Top Paper 論文(第一或通訊作者) Selected as Top Paper of ESI (first-author or correspondence-author

21、 pape)總數(shù) Total通訊作者且作者單 位為中山大學(xué)論文correspondence-author and author's work institution is SYSU總數(shù) Total通訊作者且作者單位 為中山大學(xué)論文correspondence-author and author'work institution 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/M/D科研部門審核人簽名Reviewed by (from the Departm

22、e 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 Grant/Project(No.),List of Project Members(project

23、director should be in dicated clearly), Begi nning & Ending Dates(pla nned ending date and actual ending date should be in dicated), Porti ons Resp on sible.經(jīng)費(fèi) 總數(shù)Grant(RMB)到帳 經(jīng)費(fèi)Amo unt Receive d(RMB)123統(tǒng) 計(jì)國(guó)家級(jí)National Level Grant(s)部省級(jí)Min istry/Provi ncial Level Gran t(s)廳局級(jí)Departme nt/Bureau Lev

24、el Gran t(s)其他Other Gran t(s)主持Project Director參加(前二)Participa nt (Top Three)主持Project Director參加(前二)Participa nt (Top Three)主持Project Director參加(前二)Participa nt (Top Three)Total10院系審核意見 Verification bytheDepartment/ School :審核人簽字 Reviewed by :單位（公章）Official Seal :科研主管部門審核意見Verification by the Unive

25、rsity ResearchAdministration Department :已對(duì)申請(qǐng)人在本欄目填寫的項(xiàng)內(nèi)容，包括項(xiàng)目來(lái)源及類型、目名稱、經(jīng)費(fèi)、參加者排序、申請(qǐng)時(shí)間及結(jié)項(xiàng)時(shí)間、統(tǒng)計(jì)等信 息進(jìn)行審核。Information of the itemsin the above table has been verified, including the source, type, title, amount(RMB), order of participants, beginning & ending dates and total number of gran ts/projects.

26、年月曰 Y/M/D審核人簽字Reviewed by :單位（公章） Official Seal :年月日Y/M/D七、其他與申請(qǐng)本職位有關(guān)的情況Other lnformation(in relation to this applicatio n)(如社會(huì)服務(wù)情況、其他獎(jiǎng)勵(lì)等，可另附頁(yè))(State social and community services, administrative and school services, other awards, etc. Please attach separate sheet, if necessary)八、聲明本人謹(jǐn)此聲明以上所有資料及所附證明

27、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, complete and in accorda nee with the academic moral rule. Evide nee about my ide ntity and qualificati ons can be providedfor verificati on i

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

29、打印)。Please fill in the form in both Chinese and English. Please fill out NONE when there is not any appropriate information to be filled in.Please print the form (excluding this page) in A4 paper on both sides.2若填寫內(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，

30、增加附頁(yè)，頁(yè)碼標(biāo)為附五-1、附五-2 等)。Please adjust the font size and width of the table or add columns to the table if there is not enough space. However, the content and format of each page should not be changed. The format of attachments should be in accordance with the relevant part of the main form and should

31、be labeled as ATTACHMENT-X-1 (for example, 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)：填寫專業(yè)名稱；通訊地址：填寫可以通過(guò)郵政方式接收信件的實(shí)際地址，建議填寫家庭地址。In the first part of the form: Academic Field to Applyshould s

32、pecify the sub-disciplinesField of Expertise should specify the name of subject;MailingAddress is supposed to be your home address.4. 第二項(xiàng)學(xué)習(xí)簡(jiǎn)歷：請(qǐng)從大學(xué)開始，按自然時(shí)間順序填寫，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；博士后階段按工作經(jīng)歷填寫。Educational Background: bachelordegree and above should be stated in time sequence.

33、Employment History: all employers worked for and positions held should be stated in chronological order. Postdoctoral experience 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 <核心/非核心 >/實(shí)驗(yàn))、實(shí)習(xí) /見習(xí)等。Teaching Experience Course Typerefers to Compulsor

34、y Courses (theoretical/experimental), Public Selective Courses (core liberal/ non-core liberal), Major Required Courses (theoretical/experimental), Major Selective Courses (theoretical (core/non-core)/experimental) and Intern, etc.6. 代表性論著請(qǐng)按相應(yīng)要求填寫，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

35、頂尖 A類學(xué)術(shù)期刊、在所屬一級(jí)學(xué)科(及交叉學(xué)科)公認(rèn)的權(quán)威期刊填寫，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。Representative Publications Please fill in the table according to the requirements. Please indicate the student you supervised if he/she is one of the authors. Journal

36、Category: Applicants from Humanities &Social Sciences should indicate SSCI, SCI journals with top 1% IF (Influence Factor), i nternational top-A academic journals,public-recognizedauthority journals in the first-level discipline or inter-disciplines of the field; Applicants from Science and Engineering， Medical 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 Pape