填寫報名表 / SIGN UP

*必填 (Required)


1. 報名課程 *
Course Registration
2. 中文姓名
Chinese Name
3. 英文姓名 *
English name
4. 護照號碼 *
Passport NO.
5. 護照失效日期 *
Passport expiry date

Please select the date by clicking the input box.
6. 國籍 *
Nationality
7. 在臺聯絡地址 *
Address in Taiwan		 若無請填寫「無」 Fill in "No" if None.
8. 就讀學校資訊 *
Information of your school in your country.
若無請填寫「無」 Fill in "No" if None.
若無請填寫「無」 Fill in "No" if None.
9. 生日 *
Birthday

Please select the date by clicking the input box.
10. 性別 *
Gender
11. 緊急聯絡人 *
Contact person in case of emergency
12. 在臺緊急聯絡人 *
Contact person in case of emergency in Taiwan
13. 電子信箱 *
Email Address		 寄發報到通知使用 For Registration Guidelines.
14. 特殊病症 *
Are you suffering or have you suffered in the past from any special diseases?
【如:心臟病、高血壓、糖尿病、氣喘……等】 【e.g., heart diseases, high blood pressure, diabetes, asthma, etc.】 若無請填寫「無」 Fill in "No" if None.
以上項目，請務必依實際情況填寫完整，如有因不實或未告知而造成學員生命財產安全之影響等，本院將有權利取消其參加資格，並將由報名者自行負責。
Please fill out the application form seriously and honestly. If we got the incorrect or hidden information, your application will be canceled. Besides, regard to the safety of the participants, you must be responsible for it.
15. 參加同意書 *
Permission of attending the program
茲同意本人參加國立臺灣師範大學進修推廣學院「華語橋梁:海外教師培訓計畫」活動，若有特殊飲食狀況，因特殊疾病及學員自身行為而導致學員安全問題，將自行負責，以此證明。

I hereby certify that myself can attend Mandarin Study Oversea Teacher Training Program in Mandarin as a Second Language University. If have any safe problems cause by own special diseases and behavior, I will be responsible for it.
※不同意者,歡迎未來有機會再參加本院的活動,謝謝您!
Disagree. Welcome to attend our programs in the future, thanks!
16. 請問您是從何得知本課程之訊息？（可複選）*
Where do you get the class information? (Multiple choice)
17. 其他問題詢問
Is there anything you would like to ask about the studies?		   
以上項目，請務必依實際情況填寫完整，如有因不實或未告知而造成學員生命財產安全之影響等，本院將有權利取消其參加資格，並將由報名者及其法定代理人自行負責。
Please fill out the application form seriously and honestly. If we got the incorrect or hidden information, your application will be canceled. Besides, regard to the safety of the participants, you must be responsible for it.
請確認所填寫之各項資料皆正確填寫無誤，如確認無誤並完成繳費，即視為填表人同意本校依據「個人資料蒐集、處理及利用告知聲明」蒐集個人資訊。
Please confirm that all the information you fill in is correct. Once you submit and finish the payment process, it will be considered that you have agreed the NTNU personal information collection based on the “Personal Information Collection, Processing, and Use Notification Statement.”