National Central University

Academic Exchange Student Application

Notice:
  1. Please type or print clearly this form and submit it along with other required documents (see checklist on last page) before application deadline via post.
  2. When the document issued by the institution is neither in Chinese nor English, an English or Chinese translation verified copy is required.
/ Paste one passport photo here
  1. printed on photo quality paper
  2. size: 2x2 inches
(51x51mm)
學號Student Number
(由中央大學教務處填寫To be completed by Academic Office)
Name / First Name Last Name
Chinese Name(Optional)
Nationality / Gender /  Male
 Female
Date of Birth / ______/______/______
Day Month Year / Current Academic Degree (★Important_ Check the appropriate box ) /  Doctor
 Master
 Bachelor
Home University
Academic Major at your university / Year of Study at your university
Academic Department/
Year you sought at NCU
(★Important) / 1.
2.
Please be careful to consider the department that you want to apply in NCU(list under below): http://www.ncu.edu.tw/en/academics/colleges_and_centers
English Course in NCU: https://course.ncu.edu.tw/Course/main/query/byEnglish
Permanent Home Address / Street______
State Zip/Postal Code Country
Telephone Number with country code
E-mail (please print clearly)
Current Address / Telephone Numbers
Emergency Contact Person / Name
Relationship Phone No.
Intended Semester to begin study at NCU /  Fall Semester (September to January) Year 20_____
 Spring Semester (February to June) Year 20_____
 Fall & Spring Year 20
Chinese Language / Have you learned Chinese?
Yes. Duration/Study Period ______Level: ______
No.
Signature of your current coordinator of exchange student program / (Month) (Day) (Year)

Application Checklist

All the documents should be written in English or Chinese.

One (1) copy of Application Form for Academic Exchange Student (with one passport photo)
One (1) copy of official enrollment certificate issued by Home University. It should clearly show dates of attendance, enrollment status, school and major field of study, classification, earned degrees, expected degree date, and similar information.
One (1) copy of official academic transcript issued by Home University
One (1) copy of Letter of Recommendation
One (1) copy of Letter of Nomination issued by Home University
One (1) copy of Certificate of Health Insurance (for six months)
One (1) copy of information page of passport
One (1) copy of student ID card of Home University
One (1) digital image of passport photo: it should be in JPEG file.

Signature of Applicant ______

______(Month) ______(Day) ______(Year)

Once you have received all the require documents, please email to Yishan for confirming the application, then send the hard copy of all the documents to international office before 15 November,2017.

The mailing address:

Ms Yishan Lee

Office of International Affairs, National Central University
+886-3-4227151#57083

No.300, Zhongda Rd., Zhongli City, Taoyuan County 32001, Taiwan