全財管學生海外入境調查表(109.3.2日後入境學生均須填報)Survey of Entry effective from March 2nd

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敬請3月5日至14日之旅遊史，有自歐洲、埃及、土耳其與杜拜入境者(皆含轉機)，配合政府防疫作為進行居家檢疫(14天)，切勿到校上課以免觸法

The survey of Entry is on a daily basis. Should you travel or transfer from any European countries, Egypt, Turkey, Dubai and enter Taiwan dated March.05-March.14. PLEASE DO NOT GET INTO CAMPUS OR ATTEND CLASSES or else you’re consciously going against the law.

姓名Name *

系/班年級GFM (Year) *

學號Student Number *

入境地點 Entry from / Transfer from(ex.country/ city ：Thailand /Bangkok) *

入境時間Entry Date *

YYYY

法定檢疫到期日Restrain quarantine Period from_____till______（14 days） *

YYYY

連絡電話cell phone no. *

入境後防疫措施：Mgt. Options please CHECK *

居家隔離home isolation, forbidden from leaving the house or the specified area

居家檢疫home quarantine, forbidden from leaving the house or the specified area

自主管理Self Health Mgt.(外出時全程配戴口罩)please wear a mask and take appropriate protective measures

無none

Required

入境14日內是否到校上課(請填：是/否)Have you been to attend classes after entering? *

是YES

否NO

備註(填報現居地址)Location (restrain area)Residence Address *

謝謝你的回復 thank you for your time ^_^

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