中文名

in chinese

出生日期和地點(diǎn)

Date and place of birth

文化程度

Educational Attainment

專業(yè)技術(shù)特長

Special occupational skills

健康狀況

Health condition

在北京的住址,、郵編和電話

Address,，P. O. Box and Tel No. of the foreigner in Beijing

護(hù)照種類

Type of passport

號碼

Passport No

有效期

Valid until

發(fā)照機(jī)關(guān)

Issued by

簽證種類

Type of visa

號碼

Visa No.

有效期

Valid until

簽證機(jī)關(guān)

Issued by

是否提出過延期申請（如果是，詳細(xì)列出）

Has the foreigner once applied for the extension of employment term?

本國固定住址,、郵編和電話

Regular address,，P. O. Box and Tel No. in home country

聘用單位的全稱和地址

Full name and address of the employing organization

                                                        （聘用單位印章）

郵編

P. O. Box

法定代表人姓名

Name of the Legal Representative

電話

Tel No.

申請人職業(yè)

Applicant’s Occupation

月平均工資

Salary per month

原聘用期限至

Expiration Date of Previous Term

申請延期至

Extended until

申請延期的理由

Reason for Extension of Employment Term

勞動行政部門意見

Suggestion by the labour administrative department

經(jīng)辦人：                                 核準(zhǔn)人：

Transactor：              People of ratify：

受理日期

Date of Accepted

批準(zhǔn)日期

Date of approve