國立中央大學學生退學離校手續申請表

NCU Application Form for Withdrawal from School

學生姓名 Name	學號 Student ID No.	系所 Department/ Institute	年級 Grade
申請學期 Applied Semester	學年度 第 學期 Academic year Semester
退學原因 (僅擇一) Reasons (Choose only one reason.)	□重考 Retake □工作 Occupation	□懷孕 Pregnancy □育嬰 Child Nurture	□經濟困難Economic hardship □傷病 Injury or sickness
□轉學 Transfer to Another University □台聯大轉校 Transfer to Another University in the University System of Taiwan □就讀學校、科系不符期待The student finds his/her university or department does not meet his/her expectation.
申請人 Applicant	學生家長簽章--同意本弟子辦理退學(研究生免)： Signature of the applicant’s parent who approves the applicant’s application for withdrawal from school (not applicable to postgraduates): 年 月 日 Year month day	學生簽章： Student’s signature: 年 月 日 Year month 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
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.
4會簽單位Countersign units：
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.	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（僅碩博士生須辦理）Finance (for postgraduate students only)
5教務處簽核 Ratification
5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)	核准退學離校者 在校修滿一學期具有成績 得申請轉學或修業證明書 Eligible students may apply for a Transfer or Study Certificate after completing one semester with grades.

1141218 簽核順序：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→5註冊組經辦→註冊組組長(或授權人)

Procedures: 1. Advisor → 2. Clerk at the Department→ 3. Director of the Department/Institute → 4. Countersign Units

→ 5. Division of Registrar (or Deputy)