中央大学交换学生申请表.docVIP

中央大學交換學生申請表 National Central University Notice: 請以工整字體填寫。 To be completed by student. Please type or print clearly. 請在截止日期前由學校統一送出。 Please send the application before the stated deadline. 兩吋照片張 Paste photo here (size:2”x2”) 學號Student Number (由中央大學教務處填寫To be completed by Academic Office) 姓名 Name 中文Chinese 英文English 國籍 Nationality 中 國 性別 Gender ( 男Male ( 女Female 生日 Date of Birth ______/______/________ Day Month月 Year年 最高學歷 Highest Academic Degree ( 博士Doctor ( 碩士Master ( 學士Bachelor 原就讀校名 Home University 原系所別 Department/Institute/Grade (Home University) 請務必填寫清楚原就讀學校科系、年級 申請中大 系（所）別Department/Grade in NCU 第一志願 申請中大 系（所）別 Department in NCU 2. 系(所)3. 系(所)’t be accepted by the first priority Department.) 機械系與大氣系申請者必填(缺填者將視為不合格件) Those who apply for Department of Mechanical Engineering and Department of Atmospheric Science have to select one division- ＊機械系分三組Mechanical Engineering Department： 光機電工組Opto-mechatronics 先進材料與精密製造組Advance Materials and Precision Manufacturing 設計與分析組Design and Analysis ＊大氣系分兩組Atmospheric Sciences Department： 大氣組Atmospheric Sciences 太空組Space Sciences 緊急連絡 Emergency Contact 聯絡人姓名Contact Person ___________________________________________ ________________________________________________ 聯絡電話Phone No. ________________________________________________ 通訊處 Address 永久地址Permanent Address______________________________________________________________ 通訊地址Mailing Address_______________________________________________________________ Email____________________________ Phone No._______________________ 修讀期間 Study Period 請勾選中央大學之修讀期間Please specify the semester in which you would like to study at NCU. One year will be acceptable. (上學期(九至二月) Fall Semester (September to January) Year __________ (下學期(二至六月) Spring Semester (February to June) Year __________ (一學年(九至六月) Both Semester