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中港澳入境學生管理紀錄表Log of Entry from Mainland China, Hong Kong, Macau
淡江大學商管學院全球財務管理全英語學士學位學程學生自2月11日至3月1日止，請詳實填寫個人出入境管理紀錄表，若有更新資料可重複填答，謝謝。
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姓名 Name
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學號 Student Number
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性別Gender
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男 Male
女 Female
聯絡電話 Cell Phone Number
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109.1.17後至開學前是否有中港澳旅遊史（含轉機）Entry from Mainland China, Hong Kong, Macau includes Transfer on Jan.17 2020 till Back to School day
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是Y
否(以下題目免答)N
入境時間與地點（例：109.1.25 香港）含目前尚未入境且會行經中港澳者 Entry Date / Location
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管理措施 Mgt. Options
居家隔離(不可外出)home isolation, forbidden from leaving the house or the specified area
居家檢疫(不可外出)home quarantine, forbidden from leaving the house or the specified area
自主健康管理Self Health Mgt.(外出時全程配戴口罩)please wear a mask and take appropriate protective measures
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管理措施實施時間 (例：109/1/18~109/1/31)Restrain Period from_____till______
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目前所在地Location (restrain area)
在家(stay at home)
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