National Chung Hsing University
(Year + Semester) Application for Students Applying Drop-out
Student
ID
College Department (B.S, M.S, Ph.D.) Grade
Date of (YYYY/MM
Name Gender Birth
Email：
)
Address
Contact info (mobile no.) (home)
Reason for
（Please check either one from below）
applying □Health □Economic Difficulty □Work □Pregnancy □Feeding children □Family
drop-out of □School/department does not meet expectations(Ex: transfer、Personal Interest、School
schooling environment、Academic Performance、Maladaptive)
Refund □1.Before the beginning of the school day □2.Before 1/3 of the semester □3.Before 2/3 of the semester
Procedure Sheet (You have to finish the procedure above first to start the part blow.)
Signature of Legal Guardian’s Clerk of Professor’s Stamp Director/
Library
Applicant Approval Department of Approval Chairman of Dept.
graduate students exempted (1 floor, NCHU Library)
Application Date: 家 長 導師/指導教授 系所主管
Extracurricular Student Life Student Safety OIA(for Foreign Health and Counseling Student Housing
Division students)/SSD(for
Activities Division Division Center Service Division
(military service) Overseas Chinese students)
(1 floor, Yun-Ping Building) (2 floor, Hui-Sun Auditorium) (2 floor, Hui-Sun (OIA: 3 floor, Administration (4 floor, Hui-Sun Auditorium) non-resident students
graduate students exempted Auditorium)
females exempted Hall/SSD: 2 floor, Hui-Sun) exempted
課外活動組 生輔組 學安室 國際處/學安室 健諮中心 住輔組
Clerk of Director of Dean of President
Center of Teacher Curriculum (Dean of Academic
Cashier Division Registration Registration Academic
Education Division Affairs in
Division Division Affairs charge)
If you do not take the courses (2 floor, Administration (1 floor, Administration (1 floor, Administration Hall) (1 floor, Administration (3 floor, (3 floor,
from The Center of Teacher
Education, you are exempted Hall) Hall) Hall) Administration Administration Hall)
from Hall)
師培中心 出納組 課務組 註冊組承辦人 註冊組組長 教務長 校 長
1.When one applies for drop-out from NCHU, he/she must return his/her Student ID card
備 2.Those applying for drop-out before the registration date don’t need to pay amount payment. If you apply it after the registration date, you have to make
the full amount payment, including miscellaneous fees and credit Fees.
註 3.Please turn in the complete form with all the requested stamps to the Registration Division to receive the certificate from NCHU. If you fail to finish
the process, no document from NCHU would be provided to you.
保存年限：10 年 112 年 5 月修訂
