PHOTO照片THE CHARTERED INSTITUTE OF LOGISTICS AND TRANSPORT11/12 Buckingham Gate, London, SW1E 6LBwww.ciltuk.org.ukCANDIDATE REGISTRATION APPLICATION英国皇家物流与运输学会系列证书考试认证申请表I hereby apply for admission as a Candidate in the professional examination program of the Institute of Logistics and Transport.我在此申请 ILT／CILT 证书的认证考试。I desire to take the examinations set by the Institute and to participate in the Program of the Institute to establish standards of knowledge and competency in the attempt to obtain the Certificate (Diploma) for_________________.我希望通过考试参加相关知识和能力的认证，以申请_________（级别）证书。I submit the following facts concerning my qualifications: (please type or print)以下是本人已有的资历：PERSONAL INFORMATION（个人情况）Full Name （姓名）_____________ 拼音 _______________ Sex（性别）：_____ Place of Birth（身份证号） __________________________________Company Name（公司名称） _________________________________________________Business Address （公司地址） Title（职务）________________ Zip（邮编）__________ _ _ Phone（联系电话）_________________________Mobile（手机）___________________ Preferred Mailing Address:（邮寄地址）：___________________________________________________ Zip（邮编）__________ E-Mail Address （电子邮件）：_________________________________EDUCATION （教育背景）Name and Location of School学校名称、地址YearsAttended几年DateGraduatedDegree毕业日期及学位Major Field专业或 CPLM 证书专业考试科目High School/ Technology School高中/中专College专科University本科Post-graduate研究生 Other 其它CPLM 证书互认BUSINESS OR PROFESSIONAL EXPERIENCE（工作经历）Date Month and Year年 月 日Name and Address of Employer公司名称及地址Duties and Responsibilities职务、职别From 从ToPresent 至今From 从To 到From 从To 到From 从To 到From 从To 到CAPABILITY STATEMENT（个人能力陈述）EXAMINATION DATES（考试日期） Year (年) Month (月)EXAMINATION LOCATION（考试地点） 选考科目 EXAMINATION LANGUAGE（考试语言） Chinese (中文) English (英文)DECLARATION（声明）：The information furnished herewith is warranted upon my word of honor to be true and complete and it is agreed that any material omission or misstatement shall be grounds for rejection or for withholding the Certified membership certificate of the Institute.本人声明以上内容真实可靠，并承担虚假内容导致证书无效的责任。Date （日期）_________________ Signature（签名）__________________________
