留学生请假申请表 Application Form of Leave of Absence (Class 班).pdfVIP

留学生请假申请表ApplicationFormofLeaveofAbsence(Class班)

中文姓名英文姓名国籍

ChinesenameEnglishnameNationality

护照号码联系电话去向

PassportNo.TelDestination

离校时间拟返校时间

Leave-schooltimeBack-to-schooltime

事由

Reasons

紧急联系人与联系人关系联系人电话

Emergencycontactperson(ECP)RelationshipwithECPTelofECP

请假期间，须遵守中国法律、法规，保护自身财产安全，遇到紧急事情及时和办公室老师或班主任取得联系，并报警；并

且对自己的一切行为负全部责任。

YoushallobeythelawandregulationsofChinaandensureyourpersonalandpropertysecurityduringtheperiodofleave.Ifyou

meetanyemergency,pleasereporttothepolicestationandcontactthestaffinourOfficeoryourtutorimmediately.Youarefully

responsibleforallyouractionsduringtheperiodofleave.

申请人签字：日期：返校签字：日期：

Signature:Date：Signature(back-to-school):Date：

辅导员签字：日期：任课教师签字：主管院长签字：

Tutorsignature:Date:Lecturersignature:Dean(incharge)signature:

（学院办公室留存）

留学生请假申请表ApplicationFormofLeaveofAbsence(Class班)

中文姓名英文姓名国籍

ChinesenameEnglishnameNationality

护照号码联系电话去向

PassportNo.