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(EMI 教師) 學生請益輔導紀錄表 (EMI Teacher) Students Inquiry Record
請老師提供表單給向老師請益的學生填寫此表單，謝謝
Please provide this form for students who asked questions to fill in, thank you.
* Indicates required question
Email
*
Record my email address with my response
教師名稱 Teacher
*
Your answer
課程名稱 Course Name
*
Your answer
學生班級 Class
*
Your answer
學生學號 Student ID
*
Your answer
學生姓名 Name
*
Your answer
請益日期 Date
*
MM
/
DD
/
YYYY
以下 <詢問問題> 請提供章節+題目號碼
Please provide Chapter+Question Number on the <Asked Question> section below
(ex: 第二章 第12題 CH2 Q1
2)
詢問問題 1 Asked Question 1
*
Your answer
詢問問題 2 Asked Question 2
*
只問1題 Asked only 1 question
Other:
詢問問題 3 Asked Question 3
*
只問2題 Asked only 2 questions
Other:
詢問問題 4 Asked Question 4
*
只問3題 Asked only 3 questions
Other:
詢問問題 5 Asked Question 5
*
只問4題 Asked only 4 questions
Other:
詢問問題 6 (如請益
更多問題，請
提供全部 "章節+題目號碼" ；若無請填 "無" )
Other more questions asked, please provide the rest of the "Chapter+Question number", otherwise please fill "No"
*
Your answer
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