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111特殊選才甄試防疫調查
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准考證號
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Your answer
姓名
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Your answer
手機號碼
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Your answer
陪考人員手機號碼(緊急聯絡用，陪考人員請於校園空曠處等候)
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甄試當日前14天內是否有二級以上流行地區旅遊史
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是
否
是否因「嚴重特殊傳染性肺炎(COVID-19)」，居家隔離及居家檢疫
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是
否
是否因「嚴重特殊傳染性肺炎(COVID-19)」，正進行自主健康管理
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是
否
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