中国国家留学生基金管理委员会 CSC

NO.
CHINA SCHOLARSHIP COUNCIL 派遣类别： 学生类别：
中国 北京西城区车公庄大街9号A3楼13层 100044
Level 13, Building A3, No.9 Chegongzhuang Avense Beijing 经费办法： 学习专业：
100044 P.R China
Tel:0086-10-66093900 E-mail:laihua@csc.edu.cn
Fax:0086-10-66093915 Http://www.csc.edu.cn

( The above table is only for CSC )

A P P LICATION FOR M FOR CHINE SE G OVE R NME NT

SCHOLA R SHIP

Personal Information
Agency No. Agency Name
2181 Embassy of P.R.China in Ecuador

Surname Given Name

GUAYASAMIN JENNIFER

Chinese Name Gender

Female

Date of Birth Marital Status

1999-05-28 Single

Nationality Native Language Passport No. Date of Expiration

Ecuador Spanish

Country of Birth City of Birth Religion

Ecuador Quevedo none

Personal Contact Phone Personal Contact Email Personal Contact Alternate Email
5930939255347
No. jennifersimuyguayasamin@gmail.com

Personal Contact WeChat ID Personal Contact SKYPE No.

Personal Contact Correspondence Address

Ecuador-Los Rios- Quevedo Calle tercera y zoila mata

Emergency Contact Name Emergency Contact Gender

Relation to the Applicant

Emergency Contact Phone No. Emergency Contact Email

5930939255347 jennifersimuyguayasamin@gmail.com

Emergency Contact Correspondence Address

Calle Tercera y Zoila Mata Ecuador-Los Rios-Quevedo

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Education and Employment History
Highest/Current Education
Education Level

Country of the Institute Institute Name

Universidad Tecnica Estatal De

Years Attended Field of Study

2017-11-05 -- 2027-02-19 3 semestre

Qualification (eg. BA. BSc)

none

Other Education CertificatesⅠ

Education Level

Country of the Institute Institute Name

Years Attended Field of Study

--

Qualification (eg. BA. BSc)

Other Education CertificatesⅡ

Education Level

Country of the Institute Institute Name

Years Attended Field of Study

--

Qualification (eg. BA. BSc)

Employment History
Employer

Employment Duration Work Engaged

--

Title & Position

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Language Proficiency and Study Plan
Chinese Proficiency Whether holding a HSK certificate or not?
Poor No

Level of Obtained HSK Certificate Score Obtained Test Date

English Proficiency Whether holding a certificate of English proficiency?

Good No

Name of the Test Score Obtained Test Date

Apply as Discipline Applying For

General Scholar Agronomy

Preferred Teaching Language Major Applying for

Chinese Animal Genetics, Breeding & Reproduction

Whether holding a pre-admission letter?

No

Preferences of InstituteⅠ
Guangxi University

Preferences of InstituteⅡ
Zhejiang University

Preferences of InstituteⅢ
Huazhong Agricultural University

Duration of Major Study

2021-04-16 -- 2029-12-31

Ever studied or worked in China?

No

Institute or Employer Employment Duration

--

Ever studied in China under a Chinese Government Scholarship?

No

Institute Name Employment Duration

--

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Other Contacts
Name of Contact Person or Organization in China Tel

E-mail Fax

Address
la verdad esque no conozco ningun pariente en china o alguna institucion u organizacion

Spouse's Name

Spouse's Age Spouse's Occupation

Father's Name
carlos

Father's Age Father's Occupation

52 none

Mother's Name
carmen

Mother's Age Mother's Occupation

45 none

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◆ Supporting Documents
Passport/Visa Style Photo；

Certificates of Highest Education (Notarized Copy)：

Bachelor's Degree Master's Doctor's Other

Transcripts of Highest Education (Notarized Copy)；

Study Plan；

Reference Ⅰ；
Reference Ⅱ；

Passport Home Page；

Physical Examination Record for Foreigner；

Articles or Papers Written or Published；

Examples of Art(6 color pictures)and Music(1 audio tape)Work(Only for the applicants applying for Fine Arts and
Music)；

Chinese Language Proficiency Certificate；

English Language Proficiency Certificate；

Pre-admission Letter；
Other Attachments(List Needed)： 。

Note: All supporting documents uploaded must be clear scanning copies of the original documents. Each Set of the
complete materials should not exceed 20 pages．Please use DIN A4.

◆ I Hereby Declare That：

All information and supporting documentation provided for this application are complete, true and correct；

During my stay in China, I shall abide by the laws and decrees of the Chinese government, and will not participate in
any activities in China which are deemed to be adverse to the social order of China and are inappropriate to the
capacity as a student；

I will agree to the arrangements of my institution and specialty of study in China made by CSC,and will not apply for
any changes in these two fields without valid reasons；
During my study in China, I shall abide the rules and regulations of the host university, and concentrate on my studies
and researches, and follow the teaching programs arranged by the university；

I shall go through the procedures of the Annual Review of Chinese Government Scholarship Status as required；
I shall return to my home country as soon as l complete my scheduled program in China, and will not extend my stay
without valid reasons；

If I am judged by the Chinese laws and decrees and the rules and regulations of the university as having violated any of
the above, I will not lodge any appeal against the decision of CSC on suspending, or withdrawing my scholarship,or
other penalties。

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 Statement of Applicant

China Scholarship Council (CSC)

Thank you for using the Chinese Government Scholarship Information System. Before proceeding, please read the
terms and conditions carefully. If you do not agree with any of the terms and conditions, you may choose not to submit
your application. You (the applicant) should be aware that by submitting this application, you will have consented to
the terms and conditions, regardless of the application’s final result.
1. Each applicant will be issued a username and password by the CSC after they have completed the registration
process. The applicant is fully responsible for the username and password. The applicant will be liable for activities
and events carried out under this account.

2. The applicant is fully responsible for the authenticity, legality, validity and accuracy of all the information contained
within the application. The applicants must not impersonate others and must not include any information in the
application that does not belong to them. The applicants will be unable to edit the application after the submission.
Any false or misleading information contained in the submitted application will negatively influence the scholarship
application and the applicant will be responsible for the corresponding consequences.
3. Each scholarship awardee cannot partake in more than one Chinese government provided scholarship program
during his/her study period in China. If an awardee is to have breached this rule, the CSC reserves the right to cancel
the scholarship that might already have been awarded to him/her.

4. In the circumstance that the applicant is refused by all three preferred universities of Type A application, CSC will
do its best to arrange another Chinese university to enroll the applicant. Applicants that still can not be admitted
after this process will lose the scholarship opportunity.
5. Within each enrollment year, each applicant is allowed submit no more than 5 applications, including a maximum
of 2 Type A and 3 Type B applications.

6. Terms of Privacy: User privacy is one of the CSC’s most valued principles. The CSC will strive to protect the private
information of applicants through technical, management and other measures. Once the application is submitted, the
applicants agree that the relevant data contained in the application will be provided to the dispatching authorities and
universities, for the purposes of their admissions and studies.
✓ I confirm that I have read and accept the CSC’s “Statement of Applicant”.

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