113學年度寒假返鄉調查

1.請境外生同學務必填寫。

It is required for all Overseas/ Foreign students to fill this form.

2.寒假期間(2025年1月13日到2月16日)要住宿學校宿舍的同學，請記得要填寫寒假住宿登記(表單尚未開放)。

Remember to fill the Application for Staying in the dormitory during Winter Vacation (the application has not opened yet) if you need to live in the university dormitory during winter vacation (from 13th Jan. 2025 to 16th Feb. 2025).

3.在台緊急聯絡人一欄，請留下你在台灣的親友(可以聯絡到你們的親友)的聯絡方式。

As for Emergancy Contact in TW, you can fill the name of a friend, or a classmate, or a relative in Taiwan who can contact you.

4.請同學注意居留證與護照效期。

Please pay attention to the validity period of you passport and ARC.

*學號 Student ID:

*系所班級 Department & Class:

*姓名 Name:

*僑居地/國籍 Nationality:

*在台連絡電話 Phone number in TW:

*113學年度寒假預計 Durinf this winter vacation, I plan to:

請填寫你的E-mail:

寒假要返鄉的同學，請填寫返鄉日期 If you are going home during winter vacation, please fill the date of your departure from TW:

若你寒假期間要留台，你要住哪裡？If you are staying in TW during winter vacation, you will live:

*在台緊急聯絡人姓名 Emergency contact in TW:

*在台緊急聯絡人電話 the phone/ mobile number of emergency contact in TW:

備註 memo:

*驗證碼

驗證碼語音播放器