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Leave Applicati on for I nternatio nal Un dergraduate Stude nts of ZJNU
Name:
Student ID No.:
Sex:
Date of Enrollment:
(yy) (mm) /(dd)
College/Department:
Major:
Passport No.
Nationality:
Type of fee:^ CSC Scholarship □ CIS Scholarship
ZJ Government Scholarship □ZJNU Scholarship
Self-Financed □Others
Mobile : E-mail:
Residence Address:
Duration of Absence:
From (yy) (mm) /(dd) to (yy) (mm) /(dd)
Reason for the leave
Head
Teacher s
Comments
Signature:
yy mm dd
Counselor
Comments
s
Signature:
yy mm dd
College
(Institution) s Decision
Signature:
Seal
yy mm dd
Decision from the Department for International Exchange and Cooperation
(Over 7 days leave shall get the approval from the Department for International
Exchange and Cooperation
Signature:
Seal
yy mm dd
Cancellation of Leave upon
Return
Date:
yy mm dd
Counselor s Signature:
yy mm dd
Note: This form is of two copies: one for the person who requests the leave and one for his/her counselor in his/her college (institution).
The Security Commitment by International Undergraduate Students during Absence fronisZatNIUhed on the back.
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