國立中央大學學生休學離校手續申請表

NCU Application Form for Suspension of Schooling

學生姓名 Name	學號 Student ID No.	系所 Department/ Institute	電話 Phone Number
申請休 學理由 (僅擇一) Reasons (Choose only one reason.)	列入休學年限：The following reasons are included in the term limit of suspension:
□經濟困難Economic hardship □論文撰寫Writing the graduation thesis □教師實習Teacher Intern □傷病Injury or sickness □工作Occupation □出國Going abroad	□就讀學校、科系不符期待The student finds his/her university or department does not meet his/her expectation. □學業成績不佳Unsatisfactory academic performance □就學環境Educational environment □家務或家人照顧Dealing with family affairs or taking care of any family member □因考試訓練(含研究所、公職、就業、證照考試)Training for examinations
不列入休學年限(應附證明文件)：The period of the suspension will not be included in the time limit on study if you apply for suspension of schooling for any of the following reasons (documentation should be attached): □兵役Military Service □懷孕Pregnancy □育嬰Child Nurture
休學期間 Period of Suspension	申請於 學年度第 學期 至 學年度第 學期 止 From the ___semester of academic year____ to the ___semester of academic year____	休學期滿即自動復學Automatic reinstatement upon expiration of the leave of absence period.
申請人 Applicant	學生家長簽章--同意本弟子辦理休學(研究生免)： Signature of the applicant’s parent, who approves this application of suspension of schooling (not applicable to postgraduates): 年(Year) 月(Month) 日(Day)	學生簽章Student’s signature： 年(Year) 月(Month) 日(Day)
教學單位簽核及日期Ratification and Date
1導師/指導老師 Advisor	2系所經辦 Clerk at the Department	3系(中心)主任/所長 Director of the Department/Center
4會簽單位Countersign Units (申請時為在學生狀態者須至會簽單位蓋章This step is required only if the applicant is still a student studying in school.)
體育室 Office of Physical Education	圖書館典閱組 Division of Collection and Circulation at the Library	國際事務處 Office of International Affairs
地點：依仁堂1樓 Location: Ground floor of Yi-ren Hall 大一新生開學日(含)前離校者免Freshmen who leave before (or on) the first day of school do not have to go through this step.	新生開學日(含)前離校者免Freshmen who leave before (or on) the first day of school do not have to go through this step. 清還借書與罰款請先上網查詢Return books and pay fines. Please look up your record online in advance.	僅僑生、外籍生和陸生須辦理For overseas Chinese students, foreign students and Mainland Chinese students only. 若僑生請領教育部清寒助學金者須歸還If an overseas Chinese student applying for suspension of schooling has been given a low-income household scholarship by the MOE, the student has to return the scholarship.
住宿服務組Student Housing Service Division	系所實驗室Labs
地點：國際學舍1樓 Location: Ground floor of International Student Dormitory 開學前離校者需補繳當月住宿費用。 One leaving before the first day of semester should pay the fee of the month. 離校當學期有住宿者，須先完成退宿檢查手續。 Residents need to finish the checkout procedure. 繳清修繕清潔成本費用，請至宿舍抽籤系統查詢。 Look up the fine you have to pay online.	下列系所同學須辦理 For students from the following departments only: 物理系Physics 化學系Chemistry 生命科學系Life Science 光電科學與工程學系Optics and Photonics 系統生物與生物資訊研究所Systems Biology and Bioinformatics 化學工程與材料工程學系Chemical and Materials Engineering 資訊工程學系Computer Science and Information Engineering 通訊工程學系Communication Engineering 水文與海洋科學研究所Hydrological and Oceanic Sciences 環境工程研究所Environmental Engineering 企管系（研究生須辦理）Business Administration (for postgraduate students only) 財金系（碩博士生須辦理）Finance (for postgraduate students only)
5教務處簽核 Ratification
註冊組經辦 Division of Registrar	註冊組組長(或授權人) Chief of the Division of Registrar(or Deputy)	休學核准後 得申請休學證明 每份工本費20元 Upon approval of the leave of absence, a certificate may be issued. Processing fee: NT$20 per copy.

簽核順序：

Procedures and Instructions:

1. 導師/指導老師 → 2. 系所經辦 → 3. 系(中心)主任/所長 → 4. 會簽單位(申請時為在學生狀態者才需至會簽單位蓋章) → 5. 註冊組經辦→註冊組組長(或授權人)

1. Advisor → 2. Clerk at the Department → 3. Director of the Department/Center → 4. Countersign Units (this step is required only if the applicant is still a student studying in school) → 5. Division of Registrar → Chief of the Division of Registrar(or Deputy)

學生每次得申請休學一學期至二學年。休學累計以二學年為原則，期滿因重病或特殊事故等原因需再申請休學者，經系（學位學程）主管及教務長同意，得酌予延長休學二年。

Students may apply for a leave of absence for a period of one semester up to two academic years each time.In principle, the total length of leave of absence should not exceed two academic years.If a student needs to apply for an additional leave due to serious illness or other special circumstances, an extension of up to two more academic years may be approved with the consent of the department (or degree program) chair and the Dean of Academic Affairs.

學生休學期滿即自動復學，並應於校曆規定註冊日(含)前完成註冊繳費。

Students will automatically resume their studies after the approved leave of absence period ends. Students must complete registration and pay the required tuition and fees by the registration deadline stated in the academic calendar.

若需繼續休學，最遲於註冊日(含)前提出申請；逾期未提出者，應於註冊日後兩星期內完成註冊繳費，始得依規定申請休學，並依學則第八條規定辦理退費。

If a student wishes to continue the leave of absence, the application must be submitted by the registration deadline. Students who fail to apply on time must complete registration and payment within two weeks after the registration date before they may apply for a leave of absence. Any tuition refund will be handled in accordance with the university’s refund regulations.

休學期間擬提前復學者，最遲應於註冊日(含)前提出申請，並於規定期限內完成註冊繳費。

Students who wish to return to school earlier than originally approved during their leave of absence must submit an application by the registration deadline and complete registration and payment within the required period.

學生休學期間應徵服役者，需檢具在營服役證明，申請延長休學期限，俟休學期滿檢送退伍令，申請服役期間不列入休學年限。

Students who are called up for compulsory military service during their leave of absence must submit proof of active service to apply for an extension.
The period of military service will not be counted toward the maximum length of leave of absence.

學生因懷孕、分娩或撫育三歲以下子女得檢具相關證明文件，申請休學，其休學期間不列入休學年限。

Students who apply for a leave of absence due to pregnancy, childbirth, or the care of a child under the age of three may do so by submitting relevant supporting documents.
This period of leave will not be included in the maximum allowable leave of absence.

逾期未註冊，亦未於規定期間請准休學者，應令退學。

Students will be expelled if they neither complete the procedure of registration nor apply for the suspension of schooling in due time.

休退學時間應依學生(或家長)向學校受理單位(系所)正式提出休退學申請之日為退費計算基準日。

The date on which a student (or the student's parent) applies to his or her department/institute for suspension of schooling or withdrawal from school should be the date of reference that the calculation of a tuition refund is based on.

休學期間需加入學生團體保險者，請於開學日起一週內至學務處衛保組申辦。

Students on leave of absence who wish to enroll in the Student Group Insurance program must apply at theHealth Center of the Office of Student Affairs within one week of the start of the semester.

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