Fu Jen Catholic University
Exchange Student Application Form
This application form must be reviewed and signed by your school coordinator.
Year of 20____ / 20____:
□ First Semester (Fall): ______(year), September - January
□ Second Semester (Spring): ______(year), February - June
* In Taiwan, the academic year begins in September and ends in June the following year.
First Name (given) Last Name (family)
Chinese Name (if have) Gender □ Male □ Female
Status □ Single □ Married
Date of Birth (DD/MM/YYYY) Country of Birth Nationality
Name of Home Institute:
Current Year of Study :
Bachelor:□1st □2nd □3rd □4th □5th year Master:□1st □2nd year PhD:□1st □2nd □3rd year
Current Department:
Intended Exchange Department of FJCU:
Permanent Address City
State/Province Postal Code Country
Phone Fax E-mail
+ +
Mailing Address (If different from above)
Emergency Contact Person’s Name Relationship Contact Number
Passport No. Date of Expiry (DD/MM/YYYY):
Accommodation □ on-campus → □ Fall semester □ Spring semester
□ off-campus (I will be responsible for my own accommodation)
Approximate date of arrival (DD/MM/YYYY) / /
Note:
1. Dormitory arrangement is NOT guaranteed. Any special request is unacceptable after you submit the application form.
2. Room type: triple or quad room only (bunk beds).
3. Lixue Dormitory is NOT available for exchange students.
4. No meal plans.
5. We do not provide rooms for couples.
Special health condition or disability help needed: □ No □ Yes (Please describe below)
Financial Statement
I certify that I will have all necessary funds available for the length of exchange for my study at Fu Jen Catholic University.
■ Name of person providing support:
Print: Signature:
Relationship Phone Email
+
Address
Promise
I, ______hereby affirm that all information supplied on this form is complete and accurate. I promise to obey the laws of Taiwan and the regulations laid down by the government and the university and deportation may follow a serious violation of these laws and regulations.
During my study abroad, I promise to take credits by semester according to the criteria of Fu Jen Catholic University and to finish the final examinations. I understand and agree that there will be no official transcripts or any type of academic records issued by Fu Jen Catholic University if I do not stay for the whole semester.
Finally, I do not hold the school responsible for my personal conduct or for my personal debts of fines imposed upon me for violations of laws.
Student’s Signature ______Date ______
Parent’s Signature ______Date ______
School Coordinator’s Signature ______Date ______
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Fu Jen Catholic University
Exchange Student Study Plan
Please DO NOT handwriting your study plan, computer typing only.
※ The department I want to study at FJCU is:(Choose one department only)
※ Describe your motivation for applying for FJCU exchange program. You should also include the reasons why you choose this department.
(Written in Chinese if Mandarin is the primary instruction medium at the department.)
Signature: ______Date: (DD/MM/YYYY):______
Exchange Student Application Checklist
We provide a simple checklist of all the required application materials below. Please make sure your application is complete before you submit.
□ 1. Application Form (Signed)
□ 2. Study plan/Motivation Letter (Computer typing only)
□ 3. Academic Transcript (in English)
□ 4. Recommendation Letter from a Teaching Faculty
□ 5. Current Enrollment Certificate
□ 6. Passport
□ 7. Proof of Language Proficiency (refer to our information sheet)
Document 1~7 must be scanned in colour and saved in order as one multiple-paged PDF file.
□ 8. 1 Passport-sized photo
Photo should be sent as a separate JPG file.
Note:
Fu Jen has the authority to make final admission decisions. Submitting your application successfully does not mean you are automatically accepted.
2017 Spring evaluation results shall be released in late October.
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