身心障碍学生入学考试特别安排.PDFVIP

申請表 APPLICATION FORM 身心障礙學生入學考試特別安排 Special Examination Arrangement in Admission Examination of Undergraduate Admission for Students with Disabilities 申請人必須填妥此表格，並連同相關診斷/評估報告及過往校內考試特別安排證明(如有)， 於本學年入學考試報名截止期前以電郵方式提交至本校註冊處(admission@umac.mo) 。 Applicants should complete and submit this form with medical certificates and proof of special arrangement in past school examination(s) (if any) by email to admission@umac.mo before the application deadline of the yearly Admission Examination. A. 申請人資料 PARTICULARS OF APPLICANT: 姓名 身份證護照編號/ Name in Full: ______________________________ ID/Passport No.: _______________________________________ 聯絡電話 電郵地址 Tel No.: ______________________________ Email Address: _______________________________________ B. 入學考試報考專業及科目 CHOICE OF PROGRAMMES AND EXAMINATION SUBJECTS APPLIED: 1. 報讀專業/Choice of Programmes: 第一志願 第二志願 第三志願 First Choice ______________________ Second Choice ______________________ Third Choice ______________________ 2. 入學考試報考科目/Examination Subjects applied: □中文 Chinese □ 英文 English I □數學 A Mathematics A □數學 B Mathematics B □葡語 A Portuguese A □葡語 B Portuguese B □ 物理 Physics C. 所需之特別安排 TYPE(S) OF SPECIAL ARRANGEMENTS : 1.請列出所屬 身心障礙之類別（可多選）及附上相關醫生證明或由 澳門特別行政區社會工作局發出之 「殘疾評估登記 證」 。 Please select type of disability(s) and provide medical certificates or the ‘Registration Card for Disabilities’ issued by the Social Welfare Bureau of Macao SAR: □ 視力 Visual