中央研究院人員─入境情形調查表(109/3/ 5日後返國)Academia Sinica Employees-- Arrival Survey Form (Returning to Taiwan after March 5, 2020)
大家好：

本院為能隨時掌握人員從國外返臺情形，請轉知3月5日後自國外入境之人員，填寫本調查表。


※本調查表請於入境台灣後，當日即應填妥。
※需填寫本調查表對象：109年3月5日以後入境者。


人事室 敬啟
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Dear all,

In order for AS Personnel Office to be updated on the information of AS staff’s overseas travel, please inform the staff who have returned to Taiwan after March 5, 2020 from travel abroad to fill out this form.

※This form shall be completed on the day of arriving in Taiwan.
※All arrival staff after March 5, 2020 from abroad need to fill out this form.

Sincerely yours,

Personnel Office
Academia Sinica

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單位 Unit *
職稱 Job Title *
姓名 Name *
出國地(請詳細填寫國家及城市，如：日本-東京，神奈川；德國-法蘭克福，科隆，漢堡......等) Destination (Please detail the countries and cities. For examples: Japan-Tokyo, Kanagawa; Germany-Frankfurt, Cologne, Hamburg…) *
出國事由 Reason to Travel Abroad *
出國日 Date of Departure *
MM
/
DD
/
YYYY
返國日 Date of Arrival *
MM
/
DD
/
YYYY
返國同仁風險評估表(有以下症狀，請同仁立即佩戴口罩前往就醫)Risk Assessment Form for Employees Returning from Overseas Travel *
Required
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