National Chiao Tung University Exchange Student / Visiting Student Application Form



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National Chiao Tung University

Exchange Student / Visiting Student Application Form

1. Student Information - please print clearly

First Name:………………………………………………………………………
Last Name:………………………………………………………………………
Sex:□M □F
Nationality:………….…………………………………

(Photograph)

Date of birth:…………Year………… Month………… Date



2. Contact Address - please print clearly

Current address:
Apt. No./Street:………………………………………………………………………….

City/Town:……………………………………………………………………………………….

State/Province:………………………………………………………………………………….

Country:………………………………………………………………………………………….

Postal/Zip Code:………………………………………………………………………………..

Tel:………………………………………………………………………………………………..

e-mail:…………………………………………………………………………………………….


Permanent address:

Apt. No./ Street:………………………………………………………………………….

City/Town:……………………………………………………………………………………….

State/Province:………………………………………………………………………………….

Country:………………………………………………………………………………………….

Postal/Zip Code:………………………………………………………………………………..

Tel:………………………………………………………………………………………………..

e-mail:……………………………………………………………………………………………



3. Academic Affiliation and Duration of Stay at NCTU

Field of Study:…………………………………………………………………………………..…….…

Duration of Stay:………………………………………………………………………………………….....



4. Language Proficiency

1. Chinese □Excellent □Good □Fair □Poor

2. English □Excellent □Good □Fair □Poor


3. Other …………………………………………………………………………………………………….

5. Educational Background

Educational Institute Department Duration(from/to)

1. Senior High School:.….…………………….. ….…………………… ….……………………

2. University: .……………………….. .………………………. ….…………………...


6. Permission form Home Institution

Department & Institution:……………………………………………………………….…

Name of Advisor:……………………………………………… Signature:………………………………

e-mail:…………………………………………………………………………………………..……


7. Signature of Applicant

Student Signature:………………………………………… Date:………………………………..

8. Instructions

To be enclosed:

 Curriculum vitae (CV)

 Official Transcript of Records in English

 Official recommendation in English

 Copy of student’s ID & Passpost

Application Timelines:


The Spring Semester (of the following year)- September 1 through October 31 each year;
The Autumn Semester- March 1 through April 30 each year.
Admission Office:

Office of International Affairs


National Chiao Tung University

1001 University Road


Hsinchu, Taiwan 30010, R.O.C.

Website:http://www.ia.nctu.edu.tw



E-Mail: leahhuang@mail.nctu.edu.tw TEL:886-3-513-1254 FAX:886-3-571-8685

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