基本资料basicinformation

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1、NCCUI-HouseCommonApplicationForm國立政治大學國際學生會館臨櫃申請表(Effective:Jan.1st,2011~Jun.30th,2011)RoomNo.___________ConfirmationNo.______________Date://(DD/MM/YY)OFFICEONLY※基本資料BasicInformation:學號StudentID姓名NameChinese性別Sex¨男Maleo女Female身分證/護照號碼IDNumber/Passpor

2、tNumberEnglish國籍Nationality級別Levelo博士PhDo碩士Mastero學士Undergraduate電話Tel.E-mail身分別StudentType：o交換生Exchangestudento學位生Degree-seekingstudento短期研修生(含華語生)Shorttermstudies(includingCLCstudent)申請者請隨表附上學生證正反面影本。Applicantmustattachaphotocopyofhis/herstudentide

3、ntificationcard.如申請者並未持有學生證，請由辦理該生來校業務的單位於此處簽名核章，以茲證明。IftheapplicanthasyettoacquireastudentID,pleaserefertothereceivingadministrationunitforsignatureasproofofenrollment.茲證明該學生為本校學生Thisformverifiesthisstudent’sentryatNCCU.單位承辦人員簽名/核章Signatureofthedepa

4、rtment____________________________單位主管簽章Signatureofthechairmanofdepartment_______________________________入住日Check-inDate_____________(DD/MM/YY)退房日Check-outDate__________________(DD/MM/YY)※訂房資料Reservationinformation(會館管理單位填寫TobecompletedbyI-Housemanag

5、ementunit)費用Payment:※住宿費、訂金及押金皆可使用現金或信用卡支付。Cashandcreditcardareacceptedforrentpayment,securitydepositandrentaldeposit.※訂金Deposit:半個月住宿費，需於入住前訂房時繳交，否則不予保留。三日內若未入住，房間不予保留，訂金也不退回。Studentsmustpayadepositequivalenttohalfmonth’srentuponroomreservation,orth

6、ereservationwillbeforfeited.Ifthestudentdoesnotmoveinwithin3days,wereservetherighttocancelthereservationandconfiscatethedeposit.※押金SecurityDeposit:一個月住宿費，請於入住時繳交，若採用信用卡付費則免。Studentsmustpayadepositequaltoonemonth’srentpriortorentingtheroom.Nosecurityd

7、epositiftheabovefeesarepaidbycreditcard.※付款方式WaysofPayment：□現金Cash□信用卡Creditcard種類Type:oVISAoMasterCardoAMEXoJCB卡號Cardnumber:_______-________-_________-_______到期日ExpirationDate:____________持卡人簽名Signature:__________________________日期Date:____________(

8、DD/MM/YY)國際學生會館管理單位審查：NCCUI-HouseManagementSupervision:□無床位Unavailablebed□有床位Availablebed房型Roomtypes:：□單人房Single□雙人房Twin房間號碼Roomnumber:_____________房間電話Roomphonenumber:______________宿費Rates：NT＄_____________會館人員簽章：SignatureofI-Housestaff：_____________