109學年度第1學期 中州科技大學外國學生基本資料調查109 academic year first semester of foreign students in Chung Chou University of Science and Technology Survey of basic data
請所有外國學生務必填寫此表單。
All foreign students are required to fill out this form.
請本校學生於109年08月06日（星期四）前填報本調查表回傳，謝謝！
Students of this school are requested to fill in this questionnaire before  August 6th, 2020 (Thursday), thank you!

本校電話號碼School phone number：04-8359000
國際交流中心(CIE):#1541、#1547
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1.姓名 Full Name *
2.性別Gender *
3.學號 Student ID *
4.系所名稱Department *
5.年級 Grade *
6.國籍Nationality *
7.連絡電話Cellphone Number *
例:0900-111222。EX:0900-111222
8.你的居留證號。Your Alien Residence Certificate(ARC) number. *
例:NC12345678。EX:NC12345678
9.你的居留證到期日。Your expiry date of Alien Residence Certificate(ARC). *
例:09/16/2020。EX:09/16/2020
MM
/
DD
/
YYYY
10.你在哪個縣市打工?(沒有的學生，請填無。) In which county do your part-time job? (For students who do not have , please fill in none.) *
例:彰化縣。EX:Changhua County.
13.您目前健康情形 *請就實際身體情形勾選，可複選 *
 Your current health status * Please replace the actual body part, you can check.
Required
14.您在台灣居住情形 Place Of Residence In Taiwan *
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