1、附件5 本 表 格 仅 供 参 考 ， 以 网 上 申 报 系 统 表 格 为 准Appendix 3 Please read “instructions” carefully before filling in the forms.宁波市 “3315计划 ”外裔创新人才 申报书（参考样式）Application Form of “3315 plan” for Foreign-Born Creative Talents in Ningbo(Template for Reference)申报项目 Applicant: 专业领域： （ 从填写说明的8个选项中择一填入 ）Area of expert
2、ise: (select one from 8options in the “instructions”) 专业方向： Specialty: 用人单位： Employer: 落 户 地： Place of Settlement : 申报口子： 编 号： Application sector: No: 2申报人姓名 ： Applicant: 电话 ： Telephone: 手机 ： Mobile: 邮箱 ： E-mail: 联系人姓名： Contact Person: 电话 ： Telephone: 手机 ： Mobile: 邮箱 ： E-mail: 填表日期 年 月 日Date of Fill
3、ing 中共宁波市委人才工作领导小组办公室制Prepared by the Leadership Office of Experts Work of CPC Ningbo Committee3填写说明Instructions一、封面I. Cover（一）申报口子：从教育（高校创新人才）、科技（科院院所创新人才）、人社（创业及其他创新人才）、外专（外裔创新人才）4个口子中选择外专口子填入。(I)Application sector: Select the foreign experts from 4 options: education (creative talents from higher
4、 education institutions), technology (creative talents from research institutions), social sciences (startups and other creative talents)、foreign experts(foreign-Born Creative Talents).（二）编号：由网上申报系统自动生成。(II)Number: Automatically generated and filled in by the online application system.（三）申报项目：指申报本计划
5、的项目名称。请填写中、外文名称。例如“高端氮化物LED材料及芯片关键技术”项目。(III)Project of application: name of the project are applied within this plan. Please fill out in Chinese and English format, For example, “high-end nitrides LED material and chip key technology” project.（四）专业领域：从新材料、高端装备、新一代信息技术、清洁能源、海洋高技术、生命健康、节能环保、其他等8个选项中择
6、一填入。(IV)Area of expertise: Please select one from 8 options: new material, high-end equipment, new generation of information technology, clean energy, marine high technology, life excluding the innovation talents of Colleges and unviersities,research institutions.（八）申报人、联系人电话和电子邮箱：联系人应为具体负责该项工作的人员，熟
7、悉申报人、申报材料的相关情况。联系电话请同时填写办公电话和手机号码，保证联系畅通。电子邮箱应为有效电子邮箱。(VIII)Contacts of applicant and contact: The contact Person shall be a person responsible for related work and familiar with the applicant and application materials. Please write both office telephone and mobile phone numbers to ensure contact an
8、y time.4二、申报书正文II. Application forms（一）姓名：指申报人的中、外文姓名。请填写中、外文名。(I) Name: Chinese and English names of the applicant. Please write both Chinese and English names. （二）照片：为近期小两寸正面免冠证件照。请直接制作到申报书电子文档中，并提供单独电子版照片（大小为3.34.4厘米，300 像素/ 英寸，JPT 格式）。(II) Photo: Recently taken two-inch bareheaded and full-faced
9、 ID photo. Please directly upload it to the electronic application documents and additionally provide an electronic version. (size: 3.34.4cm, 300 pixel/inch, JPG).（三）国籍、出生地及出生日期：国籍指申报人现在的国籍。请填写出生国家、地区。(III) Nationality, Place and date of birth: Current nationality of the applicant. Please write the
10、country or the region.（四）护照号码：填写目前有效的护照号码。(IV)Passport Number: Please fill in the currently valid passport number.（五）联系电话和电子邮箱：是指申报人的固定电话、手机和电子邮箱。(V) Contact telephone/e-mail: The telephone, mobile number and e-mail of the applicant.（六）现任职单位、职务（岗位）及合同时间：填写申报人目前所在单位及担任的职务。合同时间是指劳动合同中工作期限。(VI) Potenti
11、al (current) employer, title (post) and contract period: Please specify the current employer and position of the applicant. Term of Contract means work period which specified in contract.（七）已获荣誉及职称：根据实际情况选择填写。(VII) Honor / award /title: according to the actual situation to fill out.（八）教育经历和工作经历：请按照从
12、往至今的时间顺序，简要、完整描述申报人的教育和工作经历。每一段经历均应有明确的起始和终止日期，具体到月份。教育经历从大学本科填起（博士后属于工作经历）。请写清楚每阶段经历的所在国家、院校、专业、学位。学位应同时加注英文。工作经历请写清楚每阶段经历的所在国家、单位、职务。单位和职务应同时加注英文。类型为全职、兼职、访问学者。工作经历中无需描述工作业绩。(VIII)Education and work experience: Please briefly and chronologically specify the applicants education and work experience
13、. It shall include the month/year of starting and the month/year of ending. The education background shall include undergraduate education and above. Please specify country, university, specialty, and degree of undergraduate and above education and add English instructions if necessary. For work exp
14、erience, please specify country, company and tile, and add English instructions if necessary. Please mark part-time jobs. Work achievements are not required in this item.（九）专长及代表性成果：1、个人专长，请概述申报人的基本情况、个人专长、研究领域及方向。2、请列出领导（参与）过的主要项目，包括项目的起止时间、项目性质和来源、经费总额、参与人数、申报人的具体职位和任务。3、主要成果，请列出最能体现申报人水平的代表性论著（论文
15、），或专利，或产品，每类均不超5过20项。其中，论著（论文）请列出日期、名称、发表载体、全部作者，通讯作者请用“*”注明；专利请列出保护期、名称、授权国家、专利所有人等；产品请标明目前的产业化程度。4、其他，包括获得的重要奖项、在国际学术组织兼职情况、在重要学术会议上作大会报告或特邀报告情况等。(IX) Expertise and representative achievements: 1. Personal expertise, please briefly specify basic information, personal expertise, research field and
16、interest of the applicant; 2. Please specify key projects which the applicant led or participated in, including the time of starting/ending, project nature and source, gross expenditure, number of participants, applicants post and his/her task; 3. Key achievements, please specify representative work
17、s (papers), patents and products which best reflect the applicants capabilities; please give no more than 20 items for each category. For works (papers), please specify date, title, where published, all authors, and mark the correspondent author with “*”; for patents, please specify term of protecti
18、on, name, which country authorizes, patent owner, etc.; for products, please specify the degree of industrialization at present; 4. Others, including important awards, positions taken in international academic institutions, speeches or invited lectures on important academic conference, etc.（十）项目描述及工
19、作设想：包括立项的背景和意义；国内外研究现状和发展趋势、产品市场容量分析；项目主要研究开发内容、技术关键及主要创新点；项目预期目标；项目实施方案、技术路线、组织方式与课题分解；进度安排；现有工作基础和条件。(X) Work plan: The applicant shall specify jobs and detailed responsibilities which he/she takes after return to China, including work objectives, key methods, expected contributions, current found
20、ation and team, etc.（十一）竞业禁止协议：申报人是否存在竞业禁止协议，如有请列出。(XI)Non-compete agreement: The applicant has a non-compete agreement or not. If yes, please specify.（十二）破格内容及理由：如需破格，请列出破格内容并说明破格理由。(XII)Reasons and details of expective admission: If expective admission is allowed, please provide details and reason
21、s of expective admission.（十三）本人承诺：申报人须按申报系统中操作提示，将申报书承诺栏打印后亲笔签名承诺，并将承诺内容与签名扫描上传至申报系统中（未按上述要求操作，直接使用电子签名，视作无效）。(XIII) I undertake that: The applicant shall make promise with signature in the “commitment item” of the application form after print it according to the prompt of the application system，the
22、n upload it to the system ( It is deemed invalid if use the electronic signatures directly or does not operate according the above requirements ).（十四）用人单位意见：由用人单位填写。请简要说明：1、推荐申报人的主要理由，重点是申报人对本单位的不可或缺性。2、对申报人的支持措施，即从用人单位角度，为申报人提供的工作条件，包括工作平台、职务等；以及为申报人提供的6生活待遇，包括薪酬、住房等。用人单位应对申报人有关信息进行必要的核实，并对支持条件做出承诺
23、。推荐理由应避免简单重复申报人在“专长及代表性成果”栏的内容。支持条件应具体，避免笼统。属于破格推荐的，请同时说明破格理由。(XIV) Opinions by the employer: Filled in by the employer. Please briefly specify: 1. Main reasons for recommending the applicant, especially how important the applicant is for the employer; 2. Support measures for the applicant, includin
24、g work conditions provided by the employer such as work platform and position as well as remuneration, housing and other living conditions for the applicant. The employer shall verify the applicants related information and promise the implementation of support measures. Reasons for recommendation sh
25、all not be the same as “expertise and representative achievements”. Support measures shall be in details. For exceptional recommendation, please specify reasons.（十五）落户地推荐意见：各地推荐的创新人才，由所在区县（市）、开发区党（工）委组织部牵头相关部门提出意见；请简要说明以下内容：1、对申报材料的审核意见；2、提出推荐理由和当地政府的支持措施。属于破格推荐的，同时填写破格推荐的理由。市直或部省属驻甬有关单位推荐的创新人才，无需填写
26、落户地意见。(XIV) Opinions by recommending institution: For recommendations from local government authorities, the organization department of each county (city)/district, or each development zone shall organize other related departments to give opinions; for recommendations by any municipal authority or p
27、rovincial authority in Ningbo, it shall be directly filled in by the recommender. Please briefly specify: 1. Approval opinions on application materials; 2. Reasons for recommendation and support measures by local governments (recommenders). For exceptional recommendation, please specify reasons.7姓 名
28、Name中文chinese外文english性 别Sex国 籍Nationality出 生 地Place of birth出生日期Date of birth19 年(y)月(m) 日(d)护照号码Passport No.固定电话Telephone电子邮件Email近期小两寸正面免冠证件照片（JPG）Recently taken two-inch bareheaded and full-faced ID photo (JPG)手 机Mobile合同时间Term of contract现任职单位Current employer 职务（岗位）Title(Position)单位地址及邮编Address
29、 of current employer已 获 荣 誉 及 职称Honor / award /title 国 内 外 院 士 Academician 正 教 授 或 研 究 员 Professor or Researcher 副 教 授 或 副 研 究 员 Associate professor or associate inves 国 家 千 人 计 划 专 家 Expert of national 1000plan 省 级 海 外 引 才 专 项 计 划 Provincial level of overseas talents introduction学位(加注英文) 时间 国家 院校 专
30、业Degree (in C the support of relying unit for the innovation of the project team to provide funding for research and development of equipment and other supporting measures, and the implementation of the various elements of the industrialization of the project, Words not limited)您是否和其他任何单位签订过仍然有效的竞业禁
31、止协议，如果有，请列出。Do you have any effective non-compete agreement signed with any other institution? If yes, please specify. 11是否需要破格申报，如果是，请列出破格内容并说明破格理由。Need exceptional or not, if Yes, please list contents of exceptional and specify reasons.本人承诺以上信息均真实有效，并郑重承诺，自被批准纳入宁波市海外高层次人才和高端创业创新团队引进“3315计划”后，将全职在宁
32、波工作，每年工作不少于6个月，连续工作时间不少于3年。I undertake that all above information are accurate and effective, and that if this application for “3315 plan” for High-level Overseas Experts and High-end Entrepreneurial and Innovation Team in Ningbo is approved, I will work in Ningbo at least for 3 years successively a
33、nd for 6 months every year.申报人签字：Signature of the applicant:年 月 日Date: Y M D12申报人其他个人信息表Personal Information Request Form申报人： 填表日期： 年 月 日Applicant: Date of Filling: Y M D关系Relationship姓名Name出生年月Date of Birth国籍Nationality工作单位及职务Employer & Position家庭主要成员及重要社会关系 （配偶、子女、父母，配偶父母、兄弟姐妹）Family Members and S
34、ocial Relationship (spouse, children, parents of spouse, siblings)国内住址Add.& Postal Code in China国内联系电话Tel. in China国外住址Add. in Home Country国外联系电话Tel. in Home Country电子邮箱 E-mail13用人单位意见Opinions by Employer1、推荐理由（是否破格：是，不是。属破格的，请同时说明理由）：1. Reasons for recommendation (exceptional: Yes, No. If yes, plea
35、se specify reasons):2、支持措施（包括工作条件和生活待遇等方面的支持措施）：2. Support measures (involving work conditions and living conditions):申 报 人 有 关 信 息 属 实 ， 本 单 位 承 诺 予 以 上 述 支 持 ， 特 推 荐 申 报 宁波市海外高层次人才和高端创业创新团队引进“3315计划”。All information related to the applicant are accurate, and we promise to give above-mentioned supp
36、ort. We hereby recommend the applicant to apply for “3315 plan” for High-level Overseas Experts and High-end Entrepreneurial and Innovation Team in Ningbo .主要负责人签字 单位（公章）Signature of the principal Institution (official stamp)年 月 日Date: Y M D 14说 明：此表仅各地推荐外裔创新人才项目填报，市直或部省属驻甬有关单位推荐的创新所在区县（市）、开发区党（工）委组
37、织部推荐意见Opinions by Recommending Organization Department of the County/City/District, or the Development Zone, or the Municipal or Provincial Authority in Ningbo1、审核意见：1. Approval opinions: 2、推荐理由（是否破格：是，不是。属于破格的，请同时填写破格推荐意见）：2. Reasons for recommendation (exceptional: Yes, No. If yes, please specify reasons): 3、支持措施：3. Support measures: 所在区县（市）、开发区党（工）委组织部主要负责人签字：Signature of the principal of the organization department of the county (city)/district or the development zone: 单位（公章） Institution (official stamp)年 月 日Date: Y M D15人才项目无需填报。
