A-01

Application Form Application Number For Official Use Only _____________________

Application for International Students NATIONAL UNIVERSITY of TAINAN

Academic Year 2011~2012

Attach recent photograph here (about 1 x 2 )

The First Period (September 2011 entry) The Second Period (February 2012 entry)
Please read carefully, complete all sections of the form clearly, and type in BLOCK LETTERS If any discrepancy exists between the English and the Chinese versions, the Chinese version will prevail. **************************************************************************************************************************************************

A. Personal Details
English:_______________ _______________ _______________ (Surname /Last ) (as in passport) Chinese : (Middle) (First / Given) Date of Birth:_____ _____ _____ (MM)(DD)(YYYY) Sex:

B. Background

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C. Department/Graduate Institute

D. Financial Information

E. Health Condition

F. Chinese Language Proficiency

G. English Language Proficiency

I have carefully reviewed the above information and hereby certify that all of it is true and correct.
Apcns i a r __________________________________ pl t S nte i g u: a Date _________ (MM) _________ (DD) _________(YYYY)

The application forms are downloadable for free at http://web.nutn.edu.tw/gac240/951/index3_1.html

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A-02

Declaration & Authorization

Ap la t N me pi n a : c s Department or Institute: Degree to pursue: Bachelor Master Division: Doctor

I, the undersigned, declare that 1. I do not have overseas Chinese status nor hold Republic of China nationality. 2. If I formerly held Republic of China nationality, I declare that I have officially given up my R.O.C. nationality for at least eight years, up until the beginning date of the first term in which I seek admission to National University of Tainan. I also understand that a false declaration will result in the immediate cancellation of my admission or the deprivation of my status as a National University of Tainan registered student. 3. I did not apply for admission with overseas Chinese status at any university in the Republic of China. 4. The diploma(s) I present are valid and legally awarded in the country where I graduated and are equivalent to the degree conferred by accredited schools and universities in the Republic of China. 5. I understand that international students who have already completed a degree program or have been expelled from a university in the Republic of China are not eligible to re-apply for international student admission. Violation of this rule will result in immediate cancellation of my admission or the deprivation of my status as a National University of Tainan registered student. 6. I authorize National University of Tainan to verify the above statements. If there is any false declaration, I will accept the consequences as stipulated by the ninth article of National University of Tainan regulations governing academic affairs. Note I ayf sm no t nf s dn a fudui o e polsdcm n ,a ict no f n r h e r r s r t et r on s g t r ep ou et f si i f e a e u s e n h e s lf ao documents or fabrication of documents, they will be deprived of their recognized status as National University of Tainan registered students and will not be given any certificates, and the university will notify their parents or legal guardian. If it is discovered after their graduation, their diplomas will be revoked and their qualification of graduation will be deprived through official announcement. I authorize National University of Tainan to undertake a verification of the information I have provided and I authorize all corporations, companies, educational institutions, persons and former employers to release information they may have about me, and release them from any liability for doing so.

Signature of Applicant:

Date: ________(MM) ________(DD) ________(YYYY)

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A-03
Application Number For Official Use Only

Records for Document Submission

Please tick the items that you have submitted No application documents will be returned. Please make copies for yourself if needed.

Department or Institute: Degree: Bachelor Master Doctor

Division

A pi nEnglish Name p la t c s Contact Number

Tick Items of Documents 1. Application Form 2. Declaration & Authorization 3. Records for Document Submission 4. Photocopy of the Original Official Diploma copies 2 1 1

Chinese Name

Explanation

5. English or Chinese Translation of the Diploma 6. Original Transcripts and English or Chinese Translation of the Transcripts 7. Study Plan 8. Recommendation Letters

Graduating students should submit diploma when they register if admitted. If your diploma or transcripts is in Chinese or English, you are not required to submit the translated version. You can submit an English certification of degree conferral instead of an English translation of the diploma. Applicants for undergraduate studies submit high school diploma applicants for graduate studies in Mat porms s r rga submit Bachelordegree es s diploma applicants for graduate studies in Ph.D. program sb t s r degree diploma. u miMat es

1 2 One of which should be from someone who can appraise te p la t C iee r n lhl h a pi n hns o E g s anguage proficiency c s i A copy of Health Certificate issued by a hospital within the past 6 months (including Measles, Rubella and HIV virus blood serum immunity test report). The certificate includes items of general physical examination plus HIV virus blood serum immunity test report. The financial Statement is for reference purposes only. Details for tuition and expenses is spelled out in NUTN Regulations Governing Foreign Student Admission. Copies proving nationality( passport, residence certificate or birth certificate)

9. Health Certificate in Chinese or English

10. Financial Statement 11. Verification of Nationality

1 1

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A-04

Mailing Address
----------------------------------------------------------------------------------------------------------------------------------------------------

The address label below will be used for sending you the admission letter. Please key in your mailing address directly. This should be submitted together with other application documents.
----------------------------------------------------------------------------------------------------------------------------------------------------

To

Name

Address

(Contact Number)
------------------------------------------------------------------------------------------------------------------------------------------------------

How did you hear about National University of Tainan?

Internet ______ Search Engine _______ Representative _______ Exhibition/Interview program ______ Friend/family _______ Others (Please specify) ____________________________

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Application Form for NUTN International Students Scholarships 100

Chinese Name English Name Passport No. Telephone Number Cell Phone Number Branch No. Are you a citizen of the Republic of China? / Topic of thesis Total academic record For Writing Thesis Total academic credits Yes College Date of Birth Nationality Address Email Address Account No. No / / Department Year of Study Sex

Day Month Year

Total G.P.A.

Required Documents Supportive Documents

Transcripts of grades from previous semesters (new students should submit transcripts in English for the years attended in the previous academic institutions)

Recommendations
(for official use only)

Application Date

Signature

Day Month Year

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