2019 Global Summer School Program of National Tsing Hua University--Registration form/2019國立清華大學全球夏日書院報名表單

Hello everyone~We are the work team of 2019 NTHU Global Summer School Program .
We are inviting you to join us and please fill the form down below and wait for our confirmation!
Looking forward to seeing you in NTHU, Taiwan.
If you have any question, please feel free to contact us via e-mail dis@my.nthu.edu.tw. Thanks!

大家好~我們是2019國立清華大學全球夏日書院工作團隊,熱情邀請您與我們共度今年暑假,請填寫以下表單以完成報名程序,如果您有任何問題,都可以透過電子郵件(dis@my. nthu.edu.tw)與我們聯繫,謝謝! 
期待暑假相見

2019 Global Summer School Program
National Tsing Hua University
2019.03

2019全球夏日書院工作團隊
國立清華大學
2019年3月

Basic Information/基本資料
1.Full name in English/英文姓名(NOTE: the name should be consistent with your passport)*
2.Full name in Chinese/中文姓名*
3.Date of Birth/出生年月日(西元)*
4.Gender/性別*
5.Nationality/國籍*
6.Native Language(s)/母語*
7.Other languages/其他語言
8.Passport No. (For Travel Insurance)/護照號碼(旅遊平安保險用)*
9.Currently registered university or university to attend after summer/目前就讀學校(2019秋季就讀學校) 
please in the FULL name of your school. (請填全稱)*
10.Department/Program/就讀系所或專攻
please in the FULL name of your Department. (請填全稱)*
11.Degree currently pursued or obtained/就讀部別*
12.Year of study/目前年級*
13.Chinese Language Proficiency/中文能力自我檢視--Listening/聽*
14.Chinese Language Proficiency/中文能力自我檢視--Speaking/說*
15.Chinese Language Proficiency/中文能力自我檢視--Reading/讀*
16.Chinese Language Proficiency/中文能力自我檢視--Writing/寫*
17.English Language Proficiency/英文能力自我檢視--Listening/聽*
18.English Language Proficiency/英文能力自我檢視--Speaking/說*
19.English Language Proficiency/英文能力自我檢視--Reading/讀*
20.English Language Proficiency/英文能力自我檢視--Writing/寫*
Courses wish to take/欲選修的課程
Which program are you applying for? and please choose two courses and a maximum of four courses. 
【NOTE: if you choose four courses (for example, you choose course1, course2, course3 and course4), it will charge extra 400 USD for the 3rd course and 4th course. (200 USD for each)】 /請列2個或至多4個你有意願選修的課程. 
◎◎請注意,如果你加選第3門(含)以上的課程,每門課將加收200美金。 
21.Courses wish to take*
Student Contact Information/學生聯絡資料
22.Phone/電話(please add the country code)
23.Cell Phone/手機(please add the country code)*
24.E-mail Address/電子信箱(Please use your main email address for notification/請使用您常用的電郵,以確保本課程通知順利寄達) *
25.Zip Code/郵遞區號*
26.Mailing Address/郵寄地址
(For sending the course certifications, so please make sure it's a valid address)/ (用於寄送學分證明,請確保為有效地址)*

Emergency Contact/緊急聯絡人
27.Full name/全名*
28.Relationship with Applicant/與申請人聯係*
29.Phone/電話(please add the country code)
30.Cell Phone/手機(please add the country code)*
31.E-mail Address/電子信箱*
32.【IF you are over 18 years-old , please skip this question./如果你已年滿18歲,請跳過這題。】  
Declaration of parental or guardian's consent/ 父母或監護人的同意聲明書

NOTE: 
1.Students under 18 years old should get the permission of parents or persons in charge of legal custody. 
2.Please download the Declaration at 【APPLICATION】through the website (http://oga.nthu.edu.tw/ global -summer-school/lang/en). After signing (parents or guardian), please scan into PDF and upload here./未滿18歲之學員需填寫同意聲明書,請至【申請資訊】網址(http:/ /oga.nthu.edu.tw/global-summer-school/lang/en)下載同意聲明書並由學員其父母或監護人簽名後掃描成PDF檔並在此上傳
3.it can only upload once, so please be sure to upload the right ./僅供上傳一次,請再三確認上傳檔案正確性,若有問題請與我們聯繫dis@my.nthu.edu.tw。
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取消
删除
Discount/折扣
33.Recommend discount:Do you have a NTHU student to recommend you?/你有認識的清大學生推薦你嗎?

(Participants, recommended by a NTHU degree or exchange student, regardless domestic or foreign, enjoy a 20 USD discount/由本校(清大)國內外學位生或交換生推薦的參加同學將再予以美金20元折扣。)
*
34.if YES, what's her/his NAME,DEPARTMENT and YEAR?/如果有,請問他的姓名、學系和年級? 
(If NO, please fill none)(如果沒有,此欄請填無)*
35.Group discount:Do you register with your friend(s) ?/你有跟同學一起報名本次2019全球夏日書院嗎?

2 persons and above resister our courses together may enjoy a 50USD discount for each/2人以上團報,每人可享美金50元折扣*
36.if YES, what's her/his NAME and SCHOOL?/如果有,請問他的姓名和學校?
(If NO, please fill none)(如果沒有,此欄請填無)*
Others/其他注意事項
37.Dietary Restrictions(if NO,please fill None)

In welcome party, farewell party and culture trips, we will be providing meals for all students so please list any dietary restrictions you may have (ie. vegan, vegetarian, no dairy products or others)/我們會在歡迎會、歡送會及文化體驗提供餐點等,所以如果您有特殊飲食需求,請務必在此告知,例如不吃牛、不吃蛋、素食者等。如沒有特殊禁忌,請填無。
*
38.Summer School Clothing for you?/你的衣服尺寸?*
39.If you have any other suggestion/requirement, please let us know. /如果你有任何建議或需求,請讓我們知道。