115學年度網溪國小進修部入學報名表 (Wangxi Elementary School Continuing Education Division Enrollment Application Form)
請填寫此表格以申請網溪國小進修部入學。請務必提供完整且正確的資訊。Please complete this form to apply for enrollment in Wangxi Elementary School Continuing Education Division. Please ensure all information provided is complete and accurate.
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歡迎加入網溪國小進修部 Welcome to join the Continuing Education Division of Wangxi Elementary School.
報名時間：即日起至額滿為止。正取新生20位，備取生數位。歡迎二、三年級轉學生~
115學年度上學期進修部課程：115.9.2-116.1.20
115學年度下學期進修部課程：116.2.15～116.6.23
上課時間：每週一、三、四晚上6:30-9:00

Application period: From now until all spots are filled. 20 admitted new students and several waitlisted students are welcome. Transfer students in Grade 2 and Grade 3 are also welcome.

Continuing Education Division courses for the first semester of the 115th academic year: 2026/9/2–2027/1/20
Continuing Education Division courses for the second semester of the 115th academic year: 2027/2/15–2027/6/23

Class schedule: Every Monday, Wednesday, and Thursday, 6:30 PM–9:00 PM.

申請編入年級 Grade Applying For (請選擇一個年級/Please select one grade) *
身份證明文件類型 (ID Document Type) *
身分證/居留證號碼 (ID/ARC Number) *
姓名 (Name) *
生日 (Birthday) (年/月/日 - YYYY/MM/DD) *
MM
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DD
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YYYY
性別 (Gender) *
目前從事的工作類型（可複選） Current Type of Work (Multiple Selections Allowed) 
第 1 欄
☐ 學生 Student
☐ 家管／照顧家庭 Homemaker / Family Caregiver
☐ 服務業（餐飲、門市、美容等）Service Industry (Restaurant, Retail, Beauty, etc.)
☐ 勞工／技術工作（工廠、裝修、清潔等）Labor / Technical Work (Factory, Construction, Cleaning, etc.)
☐ 業務／銷售 Sales
☐ 行政／文書 Administration / Office Work
☐ 醫護／照護工作 Healthcare / Caregiving
☐ 司機／外送 Driver / Delivery Work
☐ 自營工作者／攤商 Self-employed / Vendor
☐ 軍公教 Military / Government / Education
☐ 退休 Retired
☐ 待業中 Unemployed
☐ 其他 Other：＿＿＿＿＿
原生國籍 (Nationality of Origin) *
原生國教育程度 (Education Level in Country of Origin) *
戶籍地址 (Residential Address)
戶籍電話 (Residential Telephone)
通訊電話 / 手機 (Cell Phone) *
通訊地址 (Mailing Address) *
通訊地址與戶籍地址是否相同？(Is the Mailing Address the same as the Residential Address?) *
通訊電話與戶籍電話是否相同？(Is the Correspondence Tel. the same as the Residential Tel.?) *
緊急連絡人姓名 (Emergency Contact Name) *
緊急連絡人電話 (Emergency Contact's Phone) *
緊急連絡人關係 (Relationship to Emergency Contact)
托育需求 (Child care service need) *
如有托育需求，子女性別 (If child care is needed, child's sex) *
如有托育需求，請勾選子女年齡（可複選） If child care is needed, please select the child’s age(s). (Multiple selections allowed) *
第 1 欄
☐ 1.5–3歲 years old
☐ 4–6歲 years old
☐ 7–9歲 years old
☐ 10–未滿12歲 years old
☐ 無托育需求 No child care needed
來台年資 (外國籍適用/Time of living in Taiwan - For Foreigners only) *
中文能力 (Chinese language abilities - Have you learned Chinese?) *
填表日期 (Date of filling out the form) (中華民國______年______月______日) *
MM
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DD
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YYYY
你來報名進修部的主要原因是什麼？ What is the primary reason you are applying to the Continuing Education Division? *
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