重考申請表格.pdf

REF: FAH / SR / □□□□ / 20 □□ (For FAH office use only) 人文學院 Faculty of Arts and Humanities 補考/重考申請表格 Supplementary/Re‐sit Examination Application Form 第一部分 Section I 姓名 Name 個人資料（由學生填寫） Personal Particulars (to be completed by student) 中文 Chinese 英文 English □-□□-□□□□-□ 學號 Student No 主修 Major 聯絡電話 Telephone 第二部分 Section II □ 申請詳情 （由學生及部門填寫） Application Details (to be completed by student and Department office) 補考 Supplementary Exam 此欄由部門填寫 To be completed by Department Office 課程編號 Course Code 班別 Section 課程名稱 Course Title 請選出適用者 Please tick whichever is appropriate □ 同意 Agree □ 不同意 Disagree □ 同意 Agree □ 不同意 Disagree □ 同意 Agree □ 不同意 Disagree 課程主任 / 系主任 簽署 Signed by Programme Coordinator / Head of Department 注意事項 Note:  申請人必須由考試日起 7 個工作日內提交申請表及相關證明文件。 Applicants should submit a written request with valid reason and supporting document(s) within 7 working days from the examination date. □ 重考 Re‐sit Exam 課程編號 Course Code 班別 Section 此欄由部門填寫 To be completed by Department Office 課程主任 / 系主任 簽署 請選出適用者 Signed by Please tick whichever is appropriate Programme Coordinator / Head of Department 課程名稱 Course Title □ 同意 Agree □ 不同意 Disagree □ 同意 Agree □ 不同意 Disagree 注意事項 Note:  每學期學生最多只能申請重考兩門學科。 A student may NOT take more than TWO Re‐sit examinations per semester. 本人聲明以上所述資料及相關證明文件，皆屬真實無誤。 I declare that all the information given above and relevant supporting documents enclosed are accurate and complete. 學生簽署: Signature of Student: _____________________________________________ 學院專用 日期: Date: _____________________________________________ For FAH office use only 收件蓋印 Document Received Chop _______________________________________ 學術單位主管 Head of Academic Unit _______________________________________ 輸入 Input by Date日期: Date日期: / / / / Effective from 15 May 2017 FAH/FORM/001/v001