交换生入学申请表(下载).doc

93.5.12.行政會議通過 國立高雄科技大學交換學生 入學申請表 National Kaohsiung University of Sciences and Technology Application for Exchange Student 此處貼近期相片 Attach recent photo here 415 Chien Kung Road, Kaohsiung 807, Taiwan, R.O.C. 申請人須以正楷詳細逐項填寫 TO THE APPLICANT: Read carefully and complete in DUPLICATE, type or print 姓 名 (中 文) Full name (In Chinese) ____________________ (外 文) (In English) __________ __________ _________________ (Last) (First) (Middle) 住 址 Home address ___________________________________________________________________________________ 現在通訊處 Mailing address _________________________________________________________________________________ 出生地點 出生日期 Place of birth _____________________________________ Date of birth ___________________________________ (month) (day) (year) 國 籍 性 別 婚姻狀況 子 女 Nationality _________________ Gender ________ Marital status ____________ Children __________________ 監護人姓名及住址 Name and address of legal guardian __________________________________________________________________ 父親姓名 Father’s name _______________________________ 地 址 Address ____________________________________ 出生地點 Place of birth ________________________________ 職 業 Occupation __________________________________ 母親姓名 Mother’s name _________________________________ 地 址 Address _______________________________________ 出生地點 Place of birth ___________________________________ 職 業 Occupation ____________________________________ 學 院 或 大 學 學位 日期 College or University _________________________________________ Degree ______________ Date _________ 名稱 (name) 地址 (address) 主修科目 副修科目 Major ____________________ Minor ________________ 大學研究所 學位 日期 Graduate school _____________________________________________ Degree _____________ Date _________ 名稱 (name) 地址 (address) 其 他 日期 Other Training ________________________________________________________ Date ____________________ 擬入何院系選讀 預定何時入學 Which department, college, do you intend to enter? ________________________ When? _____________________ 擬選讀何種課程 What major course of study do you expect to follow at the university? ______________________________________ 敘明在華選讀期間各項費用來源 State your plans for financing your education in Taiwan ______________________________________ 健康情形 Are you physically sound and well? __________________________________________________________________ 如有疾病或缺陷請敘明之 If not, describe any defect or health problem ___________________________________________________________ 課外活動 Extra-curricular activities __________________________________________________________________________ 著 作 出版日期 Publications _______________________________________________________ Date ________________________ 經 歷 Previous employment _____________________________________________________________________________ 曾研究中文幾年 受何人指導 How long have you studied Chinese? _______________ Under whose guidance and where? ____________________ 中國語文程度 說 How do you rate your knowledge of Chinese? Speaking ________ ____________ _________ ____________ (good) (佳) 讀 Reading ________ ____________ __________ ____________ (good) (佳) (average) (尚可) (poor) (尚差) (not at all) (不會) ________________________________________ 申請人簽名 Applicant’ s signature ________________________________________ 申請日期 Date of application (average) (尚可) (poor) (尚差) (not at all) (不會)