【附件一】 国立彰化师範大学2014年秋季.doc

【附件一】 國立彰化師範大學2014年秋季 【Appendix 】 APPLICATION FORM FOR ADMISSION TO THE APPLICANT: ˙申請人須以正楷詳細逐項填寫份。 Please complete this form in Chinese or English and print in Regular Script. ˙擬申請就讀之系所及學位 The Department/Graduate Institute and Degree you apply for: 擬申請之系所名稱 Which department or graduate program do you expect to study in NCUE? _______________________________________學院 _______________________________________系(所) 擬申請就讀之學位 What degree do you plan to pursue? 學士 Bachelor □ 碩士Master □ 博士Doctoral Degree _______年級 _______年級 _______年級 預定何時入學 When do you intend to begin your studies at NCUE? 西元 　　　　　年　　　　月 ˙如不擬攻讀學位則研習的目的為何? What are your educational objectives if you do not wish to enter a degree program? _____________________________________________________________________________________ ※個人基本資料 Personal Information 姓名（中文） 姓名（英文）（與護照上拼音一致） 外文(In The Language Full Name (in Chinese) Full Name (in English) Used at Home) (as it appears on your passport) ______________________ ________ ________ ________ __________________ (First) (Middle) (Last) 出生日期 出生地點 　 性別 □ 男 Male Date of birth _______/_______/_________ Place of Birth ________省_________市　　Gender □ 女 Female (mm) (dd) (yy) 國籍 護照號碼 婚姻狀況 子女數 Nationality ________________ Passport NO. ______________________ Marital status _______ Children ____ 住址及電話 電話 Home Address Tel ___________________________________________________ (TEL)______________________ 通訊地址及電話 電話 Mailing Address Tel ___________________________________________________ (TEL) ______________________ 電子信箱E-Mail Address __________________