国际学生疫情防控备案表International students form for epidemic prevention and control

各位亲爱的同学们：学校将于2月21日开始正式开课。根据学校疫情防控要求，所有境内学生需要填写《国际学生疫情防控备案表》，上报健康码截图、14天内动态行程卡以及相关信息。请于2月14日至2月18日前提交材料，逾期未报者不得出入学校。Hi dear students,The school will officially open on February 21. According to the requirements of the school , all international students in China needs to fill International student's form for epidemic prevention and control, students should upload the screenshot of health code, travel status within 14 days and other relevant information. Please submit materials between February 14 to February 18. Those who fail to report within the time limit are not allowed to enter and leave the school.

Q1:学号Student Number

填空1

Q2:学生类别Student category

本科生 Bachelor

硕士生 Master

博士研究生 Doctoral

语言生 Language Student

预科生 Foundation Student

Q3:护照姓名（全英文大写）Passport Name (Must be Capital letters）

填空1

Q4:性别Gender

男 Male

女 Female

Q5:国籍（尽量写中文）Nationality (Better be in Chinese)

填空1

Q6:护照号码Passport Number

填空1

Q7:手机号码Phone Number

填空1

Q8:当前所在地Current Location

校内 Inside school

青岛校外 Outside school in Qingdao

市外省内 Outside Qingdao but in Shangdong province

省外 Outside Shandong province

Q9:详细地址Detailed address

填空1

Q10:您的健康码是否为绿码?Is your health code green?

是 Yes

否 No

Q11:健康码截图 *附件 1Screenshot of your Health code *Material 1

请上传图片

Q12:接种疫苗情况Vaccination status

未接种 Not vaccinated

接种第一针 Did my first shot

接种第二针 Did my second shot

接种三针 Did my third shot

Q13:疫苗接种截图 *附件2Screenshot of vaccination status *Material 2

请上传图片

Q14:14天内行程Travel information within 14 days

无 None

出市 Traveled outside City

出省 Traveled Outside Province

Q15:14天行程卡截图 *附件3Screen shot of travel status within 14 days *Material 3

请上传图片

Q16:核酸检测证明截图（选填） *附件4Screenshot of Nucleic acid test prove (Optional) *Material 4

请上传图片

国际学生疫情防控备案表International students form for epidemic prevention and control

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