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国际教育学院调查问卷Questionnaire from International College
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学号Student ID：
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姓名Name：
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你的手机号（现在使用的号码）Mobile phone number (at which you can be contacted)
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你的邮箱Email：
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你的微信号WeChat No.：
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你现在的所在地Your current location
在自己的国家In my own country
在其它的国家In another country
请填写国家名称Name of country
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在中国In China
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3.你当前的住宿情况 Your current detailed accommodation address：
校内宿舍 On-campus accommodation
杭州校外居住Off-campus accommodation in Hangzhou
中国其它城市居住Other city in China (outside Hangzhou)
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校区（选择校区）
请选择
紫金港校区 Zijingang Campus
玉泉校区 Yuquan Campus
西溪校区 Xixi Campus
华家池校区 Huajiachi Campus
之江校区 Zhijiang Campus
舟山校区 Zhoushan Campus
海宁校区 Haining Campus
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杭州校外居住，请填写此题：区域（选择西湖区等）
Off-campus accommodation in Hangzhou：District
请详细填写小区名称、楼号及房间号Please write the Community name,Building No.and Room No.in details
上城区Shangcheng District
请详细填写小区名称、楼号及房间号Please write the Community name,Building No.and Room No.in details
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下城区Xiacheng District
请详细填写小区名称、楼号及房间号Please write the Community name,Building No.and Room No.in details
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江干区Jianggan District
请详细填写小区名称、楼号及房间号Please write the Community name,Building No.and Room No.in details
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拱墅区Gongshu District
请详细填写小区名称、楼号及房间号Please write the Community name,Building No.and Room No.in details
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西湖区Xihu District
请详细填写小区名称、楼号及房间号Please write the Community name,Building No.and Room No.in details
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滨江区Binjiang District
请详细填写小区名称、楼号及房间号Please write the Community name,Building No.and Room No.in details
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萧山区Xiaoshan District
请详细填写小区名称、楼号及房间号Please write the Community name,Building No.and Room No.in details
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余杭区Yuhang District
请详细填写小区名称、楼号及房间号Please write the Community name,Building No.and Room No.in details
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富阳区Fuyang District
请详细填写小区名称、楼号及房间号Please write the Community name,Building No.and Room No.in details
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临安区Linan District
请详细填写小区名称、楼号及房间号Please write the Community name,Building No.and Room No.in details
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桐庐县Tonglu County
请详细填写小区名称、楼号及房间号Please write the Community name,Building No.and Room No.in details
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淳安县Chunan County
请详细填写小区名称、楼号及房间号Please write the Community name,Building No.and Room No.in details
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建德市Jiande City
请详细填写小区名称、楼号及房间号Please write the Community name,Building No.and Room No.in details
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中国其它城市居住，请填写此题：省份、城市(请选择)（请详细填写小区名称、楼号及房间号）
Other city in China (outside Hangzhou)：Province/City/（Please write the Community name,Building No.and Room No.in details）
省份、城市 Province/City：
省份、城市 Province/City：
详细地址 Address in details：
详细地址 Address in details：
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你是否申请了杭州健康码？Have you got the Hangzhou health code？
是 Yes
否 Not yet
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你的健康码的颜色是？What color is your health code?
绿码Green
红码Red
黄码Yellow
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你的目前健康状况Health condition？
良好In good health
异常Feel unwell
请具体描述你的身体情况Please describe your physical condition in detail
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有无发热、咳嗽、乏力等不适症状？Any fever, cough, fatigue, etc.
无No
有Yes
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近14天内是否接触过新冠肺炎病人或疑似病例Have you been exposed to novel coronavirus pneumonia patients or suspected cases in the past 14 days？
否No
有Yes
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近14天内共同居住人员是否为新冠肺炎隔离观察对象Whether co-residents have been isolated for novel coronavirus pneumonia in the past 14 days？
否No
是Yes
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你近期是否计划离开现在的居住地前往其他国家Are you planning to leave your current residence for other countries in the near future？
否No
是Yes
请写下你的计划（时间+国家+城市，例：3.20马来西亚吉隆坡）Please write down your plan（Date/Country/City，3.20/Malaysia/Kuala Lumpur）
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我已认真阅读《
关于国际学生不提前返校、不提前来华的通知
》，并且承诺能够遵守通知上的各项要求I have read the above Notice for International Students on No Returning to University or to China Without Official Notice. I will abide by all requirements in the Notcie.
是Yes
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