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姊妹校交流營報名表(20161020新建)
姊妹校交流營報名表
交流營1/Camp 1:
交流營2/Camp 2:
中文姓名:
護照英文姓名/Full Name as on passport:
生日/Birthday(YYYY/MM/DD):
性別/Gender:
女female 
男male 
學位別/Degree:
學號/Student ID No.:
學生證正反面/Student ID Copy:
系所/Department:
年級/Year of Study:
前一學期平均成績/GPA of the Last Semester:
手機號碼/Mobile Phone No.:
信箱/Email Address:
身分證字號/ID No.:
身分證正反面/Passport Copy:
護照號碼/Passport No.:
臺胞證號碼/Mainland Travel Permit No.若無請填無:
飲食習慣/Dietary Habits:
葷食/Non-vegetarian 
素食/Vegetarian 
忌諱飲食/Food Taboos:
緊急聯絡人姓名/Emergency Contact Person's Name:
與緊急聯絡人關係/Relationship:
緊急聯絡人電話/Emergency Contact Person's Phone No.:
緊急聯絡人信箱/Emergency Contact Person's Email Address:
是否曾擔任國際處接待義工?/Have you ever been an OIA volunteer?:
是/Yes 
否/No 
擔任義工學期/Volunteer Semester:
擔任義工接待姊妹校/Receiving Universities:
是否曾參加姊妹校交流營/Have you ever participated in a student camp?:
姊妹校交流營名稱/Camp Name:
姊妹校交流營西元年/Camp Year:
如獎學金名額沒有錄取是否報名自費名額參加(此題回答不影響參加資格):
是 
否 
申請人簽名/Applicant's Signature:
*
請輸入此驗證碼 更換驗證碼