國立勤益科技大學外籍學生中港澳入境調查表 International Travel & Contact Polling on NCUT International Students
為因應新冠肺炎疫情,教育部來函調查本校中港澳入境及轉機之學生及教職員工是否進行自主管理,敬請各位同學協助填寫本調查表,來函請參考
To cope with Novel coronavirus pneumonia global outbreak, Ministry of Education (MOE) requires all schools to complete international travel & contact polling on students/teachers/employees. Please fill the form according to your identity.
https://irw.ncut.edu.tw/doc/2019-nCoV.pdf

*注意事項:
1. 應如實填報,如有拒絕、規避或妨礙各級政府機關所定之檢疫、防疫措施,將依違反「傳染病防治法」規定論處。
2. 依本校學生獎懲規定第11條第6款(記大過兩次小過兩次)或第13條第2款(開除學籍),未遵守規定與據實填報者,將處大過以上,最嚴重者將開除學籍。
基本資料 Basic Information
填報欄位為回報本校現況所須,務請協助填寫
學號 Student ID No. *
Your answer
姓名 Name *
Your answer
性別 Gender *
連絡電話 Contact phone *
手機為佳 Mobile preferred
Your answer
所屬單位 Department or division *
系所班級 Class *
Your answer
是否途經中港澳地區並於 1/16 日後返國 Do you pass through China, Hong Kong and Macau and return to Taiwan after 1/16 ? *
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