長庚大學外薦雙聯學生入學申請表         Chang Gung University Application for Incoming Dual-degree Students
Admission permit will be prepared with the following information; therefore, all the information must match your passport information.

Fall semester: from mid-September to mid-January
Spring semester: from mid-February to mid-June


PRIVACY AND ACCESS TO YOUR FILE
 
Privacy statement: 
All information on the application form is private. Information requested will be used for identification, to determine admission, and to establish your University academic record if you are admitted. Failure to provide  the information may delay or affect the admission decision. Information will be shared with offices within the University for the uses described above and may be released to outside and government bodies in limited circumstances as authorized by the applicant or by state or federal law.

Special notice regarding release of information in the application: 
The Chang Gung University may request University staff, faculty, alumni, and/or students to assist you with questions concerning the University and to provide you with additional information. This would be done under the direction of the Office of International Affairs staff. The type of information that may be released includes name, address, phone number, classification (freshman or transfer, major, and most recent educational institution attended).  

By signing this form, you agree to the following statements: 
"I certify that all statements made on this application and all other application materials are complete, true, and accurate to the best of my knowledge. I understand that misrepresentation or fraudulent information is sufficient ground for canceling my admission or registration. I further understand that failure to promptly notify the Office of International Affairs, as required on the residency information page, or any criminal charge or conviction prior to enrollment is sufficient grounds for canceling my admission or registration. I understand that Chang Gung University may release my name, email address, and phone number to current and potential dual-degree students."
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申請人資料 Personal Information
英文姓名 English Name (surname and given name, e.g. WANG David) *
中文姓名 Chinese Name (if any)
性別 Gender
*
出生日期 Date of Birth
*
MM
/
DD
/
YYYY
出生地 Place of Birth
*
國籍 Nationality
*
護照號碼 Passport No.
*
通訊地址 Mailing Address
*
聯絡電話 Phone Number
*
電子郵件 E-mail Address
*
繼續
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