Microsoft Word Kun Shan University Application Form for International Students---

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206 崑山科技大學國際學生入學申請表 206 Application Form for International Students Online Application Website: /eng/unit/d/a/io/pagedetail/068/ Contact Information Office of International Affairs,

1 206 崑山科技大學國際學生入學申請表 206 Application Form for International Students Online Application Website: /eng/unit/d/a/io/pagedetail/068/ Contact Information Office of International Affairs, Address: No. 95, Kunda Rd., YongKang District, Tainan City 7070, Taiwan (R.O.C.) Tel: Ext. 258 Tel: Fax: Website : /eng/

2 ( 每人限勾選一項 Tick one only!) Apply for Fall Semester. Application Deadline: May 3 st. Apply for Spring Semester. Application Deadline: October 3 st. Attach 2 recent photographs here (or 2 inches) TO THE APPLICANT: Read carefully and complete in type or handwrite. For more detailed information, please refer to the General Application Regulations. 申請人資料 Personal Information 英文姓名 Full Name in English: 中文姓名 Full Name in Chinese: First Name Middle Name Last Name ( 須與護照姓名相同 Please provide the name as passport shows) (If applicable) 性別 Gender: 男 Male 女 Female 婚姻狀況 Marital status: 單身 Single 已婚 Married 國籍 Nationality: 護照號碼 Passport No.: 護照有效期限 Passport Expiry Date: 生日 Date of Birth: / / ( Day / Month / Year ) 居住地址 Home Address: 郵寄地址 Mailing Address: 電子郵件父親姓名 Father s Name( 名 First/ 姓 Last): 手機號碼 Mobile: 國籍 Nationality: 母親姓名 Mother s Name( 名 First/ 姓 Last): 手機號碼 Mobile: 國籍 Nationality: 聯絡電話 Telephone: (i.e.+886(taiwan country code)-6(district code)-number) 手機號碼 Mobile: 2 學歷 Educational Background 學位 Degree 學校名稱 Name of School 國家 City and Country 修業起訖年月 Duration (from/to) 主修 Major 中學 Secondary School 學院或大學 College / University 研究所 Postgraduate 2

3 工作經驗 Working Experience 社團經驗 Association Experience 3 修業計畫 Program you are applying for:( 每人限勾選一項 Tick one only!) 3. 英語授課課程 English-taught Program 國際機械工程學士學程 International Bachelor Program in Mechanical Engineering 國際機械工程碩士學程 International Master Program in Mechanical Engineering 國際企業管理碩士學程 International Master Program in Business Administration 3.2 華語授課課程 Chinese-taught Program 學士課程 Bachelor Program in Department of 研究所 Postgraduate Program in Department of 博士班 Ph.D Program of Mechanical and Energy Engineering * 請附上申請動機與讀書計畫 Attach a statement in English stating your reason for studying and your study plan in Taiwan. 4 語言能力 Language Proficiency 英文 English 聽 Listening 優 Excellent 佳 Good 尚可 Average 差 Poor 說 Speaking 優 Excellent 佳 Good 尚可 Average 差 Poor 讀 Reading 優 Excellent 佳 Good 尚可 Average 差 Poor 寫 Writing 優 Excellent 佳 Good 尚可 Average 差 Poor * 請註明下列語言檢定成績 Please indicate the following information if available: 英文為母語 Native English Speaking 托福 TOEFL Score: 多益 TOEIC Score: 雅思 IELTS Score: 中文 Chinese 聽 Listening 優 Excellent 佳 Good 尚可 Average 差 Poor 說 Speaking 優 Excellent 佳 Good 尚可 Average 差 Poor 讀 Reading 優 Excellent 佳 Good 尚可 Average 差 Poor 寫 Writing 優 Excellent 佳 Good 尚可 Average 差 Poor * 請註明下列語言檢定成績 Please indicate the following information if available: 中文為母語 Native Chinese Speaking 華語測驗等級 TOCFL Level: 華語測驗分數 TOCFL Score: 3

4 5 學費來源 Financial Support ( 每人限勾選一項 Tick one only!) 自己 Self 家人 Parental Support 政府 Government 6 是否是否領取任何政府領取任何政府獎學金?Have you obtained any Government Scholarships? 否 No 是 Yes 外交部臺灣獎學金 MOFA Taiwan Scholarship, 其他 Others, please specify 4

5 切結書 Declaration ( 請詳細閱讀並逐一確認 Please read it carefully and tick all boxes that apply.). 本人保證不具中華民國國籍法第二條所稱中華民國國籍 I hereby certify that I do not hold the nationality of Republic of China. (Please refer to Article 2 of Nationality Law of the Republic of China for ROC Nationality Definition.) 2. 本人保證曾具有中華民國國籍, 但自內政部許可喪失中華民國國籍之日起至今已滿八年 I hereby certify that I have not been a citizen of the Republic of China in the last eight years. This cover the period between the day of annulment of my citizenship of the Republic of China as approved by the ROC Ministry of Interior and the first day of a new semester at. 3. 本人保證不具僑生身份且在台並未以僑生身份申請大學校院 I hereby certify that I do not possess overseas Chinese student status or have previously applied to colleges/universities with this status in Taiwan. 4. 本人所提供之最高學歷畢業證書在畢業學校所在國家均為合法有效取得畢業資格, 所持之證件相當於中華民國國內之各級合法學校授予學位 I hereby certify that the certificates of the highest-level diploma I provide are valid and authentic from my school, and they are equivalent to the degree level that universities/institutes offer in the Republic of China. 5. 本人不曾在台以外國學生身份完成高中學校學程, 或未曾經國內大學校院退學 I hereby certify that I have not finished high school programs in Taiwan with international student status, or ever dropped out/withdrew from colleges/universities in Taiwan. 6. 上述所陳之任一事項同意授權貴校查證, 如有不實或不符規定等情事屬實者, 本人願依貴校相關規定辦理, 絕無異議 I hereby authorize to verify any information provided above. I am willing to follow the rules and regulations of without any objections should the information provided be found untruthful. 申請人簽名 Signature of Applicant: 日期 Date: (dd/mm/yy) 5

6 No 繳交資料確認表 Check List (Please tick the items that you have submitted.) 申請資料項目 Required Materials 國際學生入學申請表 Application Form for Admission with two recent passport-size photos 曾具有中華民國國籍申請者, 請檢附喪失中華民國國籍證明 Certificate stating that the applicant who has had or once had dual nationality has lost his/her citizenship to the Republic of China. 經認證之最高學歷英文或中文畢業證書 One photocopy of official highest degree diploma with verification by Taipei Economic and Cultural Office or Taiwan Embassy. (English or Chinese verified version is also necessary if the original diploma is not in either language. The original verified certificate shall be submitted upon registration at the beginning of the new semester.) 經認證之英文或中文成績單 One photocopy of complete highest degree transcript with verification by Taipei Economic and Cultural Office or Taiwan Embassy. (English or Chinese verified version is also necessary if the original transcript is not in either language. The original verified transcripts shall be submitted upon registration at the beginning of the new semester.) 05 推薦信 Recommendation Letter 2 份數 Copies 確認 Check 06 自傳 Autobiography 07 研究計畫 Thesis Proposal ( 碩士學程申請者 Master program applicants) 08 財力證明 One photocopy of official bank statement, with a minimum balance of US$6,000 per person. (The original bank statement shall be submitted upon registration at the beginning of the new semester.) 09 護照影本 Photocopy of Passport 0 健康檢查證明 Health Check Certificate 2 3 語言能力證明文件 Language Proficiency Certificate 托福 TOEFL 雅思 IELTS 多益 TOEIC 華語文能力測驗 TOCFL 其他 Others: 獎學金證明文件 Scholarship Recipients Certificate 外交部臺灣獎學金 MOFA Taiwan Scholarship 其他 Others: 其他相關文件 Other Supported Documents (if any) 居留證影本 A photocopy of ROC Alien Resident Certificate 其他 Others: * 所有文件皆需以英文或中文繳交 All of the documents must be submitted in English or in Chinese. 申請人簽名 Signature of Applicant: 6

7 Office of International and Cross-Strait Affairs Personal Information Collection Agreement Acting according to Article 8 of the Personal Information Protection Act, the Office of International and Cross-Strait Affairs of (hereinafter referred to as the Organizer) hereby discloses to you the following information that you should read carefully before filling out the application:. The Organizer has to collect personal information about you to process the Application for Enrollment and Exchange Student Status from Foreign Students or the Application for Exchange Student Status Overseas from Students. The collection, processing and use of personal information about you shall be subject to regulations set forth in the Personal Information Protection Act and related laws. The personal information to be collected and used this time is as listed in the application form. The said information will be used in evaluation and selection meetings and posted online. It includes the name, department and nationality of the student, etc. The use will be permanent. The user will be the Organizer. 2. You may act according to Article 3 of the Personal Information Protection Act and apply to the Organizer for access to, duplication of, or presentation of supplementations or changes to the personal information about you that the Organizer has collected or request the Organizer to stop collecting, processing or using such information. However, with information that the Organizer has to retain in order to execute its duties as required by law, the Organizer may not comply with your request. 3. You have the liberty to decide whether to provide your personal information. However, if you refuse to provide related personal information, the Organizer will be unable to accept your application. Applicant Signature/Seal: MM DD YY 7

Note: Please send your application documents to: E-mail: oiae@mail.ksu.edu.

8 Note: Please send your application documents to: (electronic file) ( subject: 206 KSU Applicants) Or send your original copies to: Office of International and Cross-Strait Affairs (206 KSU Applicants), Address: No. 95, Kunda Rd., YongKang District, Tainan City 7070, Taiwan (R.O.C.) Tel: Ext. 258 Tel: Fax: Please save a copy as well in case there s any problem when delivering the documents. 8

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