附表一 (Appendix 1)

1.外國學生繳交資料檢核表

Application Checklist

檢核 check	繳交資料項目 Required Documentation	份數 Copies
入學申請表 Application Form for International Student Admission	1
入學申請切結書 Affidavit for Application	1
授權查證同意書 Authorization	1
文件驗證切結書 Affidavit (of admissions documents to be verified)	1
外國學生申請人在臺就學檢核表及切結書 The check-list & affidavit letter of attendance for foreign applicants in Taiwan	1
最高學歷證書(中、英文以外之語文，應附中文或英文譯本) The highest educational diploma authorized by the Taiwan Overseas Representative Office (notarized copy translated in English or Chinese is necessary if the original diploma is not in English or Chinese)	1
最高學校成績證明(中、英文以外之語文，應附中文或英文譯本) The highest educational transcript authorized by the Taiwan Overseas Representative Office (notarized copy translated in English or Chinese is necessary if the original diploma is not in English or Chinese)	1
英文檢定成績或華語文能力證明(母語非華語之申請人應繳交) Recommendation Letter Chinese Proficiency (Applicant whose mother language is not Mandarin shall submit the document)	1
護照影本或其他國籍證明文件 Copy of passport or other equivalent verification nationality	1
財力證明書 Financial Statement	1
自傳 Autobiography	1
讀書計畫書 Study Plan	1

※所有申請文件一律不退還，請自行保留備份。

No application documents will be returned. If required, please make copies for your records.

申請人簽名 日期

Applicant’s Signature Date

附表二 (Appendix 2)

2.醒吾科技大學114學年度外國學生入學申請表

Application form for International Students

Hsing Wu University of Science and Technology

Academic Year 2025

請以中文正楷逐項填寫/ Please type or print clearly in Chinese

欲申請就讀之系所及學位 Which department and what degree do you wish to apply at HWU?	最近2吋照片 recent photo (Approx.size:1”x2”)
系所(必填) Department / Institution
學位(必填) Degree Granted	□學士Bachelor □碩士Master

1.申請人資料：Personal Information

姓名 Full name	中文(Chinese)	出生日期 Date of Birth	/ / (DD/MM/YYYY)
英文(English)	性別 Gender	男 Male 女 Female
住址 Home Address	電話 Telephone
手機 Mobile Phone
通訊住址 Mailing Address	E-mail
國籍 Nationality	出生地點Place of Birth	護照號碼 Passport No.
WhatsApp:	WeChat:	Line:

2.監護人資料：Guardian Information

申請人父親Applicant’s Father	申請人母親Applicant’s Mother
英文姓名Full Name in English	國籍Nationality	英文姓名Full Name in English	國籍Nationality
出生地點Place of Birth	出生日期Date of Birth	出生地點Place of Birth	出生日期Date of Birth
職業Occupation	地址Address	職業Occupation	地址Address

在台聯絡人 Contact Person in Taiwan (optional)
姓名Full Name:	聯絡電話Phone No.:
地址Address:

3.教育背景：Educational Background

學歷 Previous Education	中等學校 Secondary School	學院或大學 College or University	其他 Others
學校名稱 Name of School
學校所在地 City and Country
學位 Degree Granted
畢業日期 Graduation Date
主修/副修 Major/Minor

4.語言能力：Language Proficiency

中文/Chinese：母語為華語/Mother language is mandarin: 是/Yes □ 否/No □

聽Listening	□優Good	□尚可Average	□差Poor	□不會None
說Speaking	□優Good	□尚可Average	□差Poor	□不會None
讀Reading	□優Good	□尚可Average	□差Poor	□不會None
寫writing	□優Good	□尚可Average	□差Poor	□不會None

英文/English：

聽Listening	□優Good	□尚可Average	□差Poor	□不會None
說Speaking	□優Good	□尚可Average	□差Poor	□不會None
讀Reading	□優Good	□尚可Average	□差Poor	□不會None
寫writing	□優Good	□尚可Average	□差Poor	□不會None

5. 財力支援狀況Financial supports: What is your financial resource while you study at HWU ?

個人儲蓄Personal Savings	□ 台灣獎學金 Taiwan Scholarship
□ 父母支援Parental Support	□ 其他Others

附表三 (Appendix 3)

3.外國學生切結書

Declaration for International Students

一、 本人保證： 1.未曾具有中華民國國籍，於申請時也不具僑生資格。 2.具外國國籍，申請時兼具中華民國國籍，自始未曾在臺設有戶籍，且以2025年8月1日往前推算已連續居留海外6年以上。(不含居留大陸地區、香港及澳門，且每曆年在中華民國國內停留期間不得逾120日) 3.具外國國籍，申請前曾兼具中華民國國籍，於申請時已不具中華民國國籍，自內政部許可喪失中華民國國籍之日起至 貴校開學起始日(2025年8月1日)止已滿8年，且於2025年8月1日往前推算已連續居留海外6年以上。(不含居留大陸地區、香港及澳門，且每曆年在中華民國國內停留期間不得逾120日) 4.本人未曾以僑生身分在臺就學，且未於當學年度接受海外聯合招生委員會分發。 I hereby certify that: 1. I have never possessed R.O.C. nationality and was not an Overseas Chinese student at the time of application. 2. I do not possess both foreign and R.O.C. nationality at the time of application. I have never applied for Taiwan household registry and have continuously resided abroad for at least 6 years prior to August 1, 2025(not including Hong Kong, Macau or the People’s Republic of China. During the six year period prior to August 1, 2025, I have not stayed in Taiwan for more than 120 days during any single calendar year.) 3. I have foreign nationality and if I held R.O.C. nationality prior to the time of application, I have ceased to posses R.O.C. nationality during the time of application. And according to the Ministry of the Interior R.O.C., I have ceased to possess R.O.C. nationality for at least 8 years prior to the start of the fall academic semester (August 1, 2025). I have continuously resided abroad for at least 6 years prior to August 1, 2025 (not including Hong Kong, Macau or the People’s Republic of China. During the six year period, I have not stayed in Taiwan for more than 120 days during any single calendar year.) 4. I have not studied in Taiwan as an Overseas Chinese student. This year I did not accept a placement from the University Entrance Committee for Overseas Chinese Students. 二、本人所提供之最高學歷畢業證書(報名大學部者為高中畢業證書、研究所者為大學或碩士畢業證書)均為教育部認可、經駐外單位驗證屬實，保證於錄取報到時繳交經駐外單位驗證之外國學校畢業證書正本。(中文或英文翻譯本) The diploma I provided (secondary degree diploma for applying for undergraduate program, bachelor or master’s degree diploma for graduate program)is recognized by the Ministry of Education and verified by the Taiwan’s overseas representative office. Upon registration, a photocopy of the certificate of diploma obtained from a foreign education institution and verified by the Taiwan’s overseas representative office shall be submitted with a notarized translation in either Chinese or English. 三、本人所提供之所有相關資料(包括學歷、護照及其他相關文件之正本及其影本)均為合法有效之文件，如有不符規定或變造之情事，經查證屬實即取消入學資格，且不發給任何有關之學分證明。 All relevant documents provided (including diploma and passport, originals or copies ) are valid. Should I violate any university regulation, my admission to HWU will be denied, and no proof of attendance will be issued. 四、本人未曾遭中華民國各大專校院退學。如違反此規定並經查證屬實者，取消其入學資格並註銷學籍。 I have never been expelled from other colleges and universities of the Republic of China. Should I breach any of the regulations, I will be denied admissions and student status. 五、本人同意報名所填各項資料，由 貴校依據「個人資料保護法」等相關法令規定為必要之資訊應用處理相關事宜。 I accept that all application materials, will be dealt with by HWU according to the “Personal Information Protection Act” and all regulations pertaining to it as deemed necessary. 六、上述所陳之任一事項同意授權貴校查證，如有不實或不符規定等情事，於入學後經查證屬實者，本人願意接受貴校註銷學籍處分，絕無異議。 I authorize this school to check on all of the above information. If any information is found to be false before I am admitted to HWU, the information above is subject to further verification. Should any information be found false after being admitted to HWU, I have no objection to being deprived of registered student status. 申請人簽名Applicant’s signature: 日期Date:

附表四 (Appendix 4)

4.授權查證同意書

Authorization

我授權醒吾科技大學查證我所提供的資料，我並授權：

I authorize Hsing Wu University of Science and Technology to undertake verification of the information I have provided and I authorize the relevant：

□ educational institutes, 學校

□ staff, 相關負責人員

□ others 其他

提供關於我的資料，並使他們免責於此一行為。

To release information they may have about me, and release them from any liability for doing so.

Full Name 姓名（全名）____________________________________________________________

Signature 簽名（全名）____________________________________________________________

Passport Number 護照號碼________________________________________________________

University (Graduate School) Student ID Number 大學（研究所）學生證號________________

Date of Birth 生日________________________________________________________________

Date 日期_______________________________________________________________________

附表五 (Appendix 5)

5.文件驗證切結書

Affidavit (of admissions documents to be verified)

本人 申請貴校 ，外國學生申請入學，

(姓名 Name) (申請系所)

保證於報到註冊時補交下列文件：

I, , applying for the

(Full name) (Program name)

at Hsing Wu University of Science and Technology, hereby promise that I will submit the following verified documents to Hsing Wu University of Science and Technology at the time of registration.

註記 Check()	項目 Items
經駐外單位驗證之國外最高學歷證件正本一份。 One original highest educational diploma verified by the Taiwan Overseas Representative Office.
經駐外單位驗證之國外最高成績證明正本一份。 One original highest educational transcript verified by the Taiwan Overseas Representative Office.

若在報到時無法提供繳驗經駐外單位驗證之學歷證明及成績單正本；本人願放棄錄取資格，絕無異議。(※中英文已外之語文，應附經驗證之中文或英文譯本)

Furthermore, at the time of registration I will present my original diploma and transcript to Hsing Wu University of Science and Technology. I understand that if I cannot submit the copies of the verified ocuments or the original diploma or transcript at the time of registration, my qualification for enrollment will be revoked.

(Remark: If the original documents are not in English or Chinese, an English or Chinese translation version verified by a Taiwan overseas representative office is also required.)

切結人簽章 Applicant’s signature 日期 Date:

附表六 (Appendix 6)

6.外國學生申請人在臺就學檢核表及切結書

外國學生申請人是否曾以僑生身分在臺就學檢核表 The form is used to ensure whether the applicants studied in Taiwan as Overseas Chinese students. 依據「外國學生來臺就學辦法」第2條規定，外國學生須未曾以僑生身分在臺就學，為確認您的外國學生身分，請確實填寫回答以下問題，謝謝！ According to Article 2, "International Students Studying in Taiwan", International students must have never studied in Taiwan as Overseas Chinese students. Please complete and answer the following questions to confirm your international student status. Thank you! 請問您是否曾經來臺就學過？是□ 否□ (若填寫否，則無需回答以下問題) Have you ever come to Taiwan to study? Yes□ No□ (If No, you do not need to answer the following questions) 請問您是否曾以僑生身分在臺就學？是□ 否□ 不確定□ Have you ever studied in Taiwan as an Overseas Chinese student? Yes□ No□ Ambivalent□ 請問您是否曾經海外聯合招生委員會分發？是□ 否□ 不確定□ Have you been registered by the Overseas Chinese Students Admissions Committee? Yes□ No□ Ambivalent□ 請問您是否曾經各校以自行(單獨)招收僑生管道入學？是Yes□ 否No□ 不確定□ Have you ever applied yourself (without an agent) to a university in Taiwan and been accepted as an overseas Chinese student? Yes□ No□ Ambivalent□ 請問您本學年度是否向海外聯合招生委員會申請來臺就學？是Yes□ 否No□ For this semester, did you apply to study in Taiwan through the Overseas Chinese Student Admission Committee? Yes□ No□ 填表說明：若您於第1題或第2題填寫「否」之選項，請填寫下列切結書。 Notes: If you fill in the "No" option in question 1 or question 2, please fill out the following declaration letter
切 結 書 DECLARATION LETTER 申請人____________(姓名)為具____________國籍之外國學生，申請本年度來臺就讀醒醒吾科技大學，本人確認未曾以僑生身分在臺就學，倘經僑務主管機關查證具僑生身分，則由錄取學校撤銷原錄取資格，不得異議。 Applicant ____________ (name) is a foreign student from ____________ (Nationality), enrolled in Hsing Wu University of Science and Technology, I certify that I have never studied in Taiwan as an Overseas Chinese student, if the Overseas Chinese affairs authority verifies that I have Overseas Chinese student status, qualification admission must be revoked by the admissions school without objection. 此致 Sincerely, 醒吾科技大學Hsing Wu University 立切結書人(Name of Applicant)： 護照號碼(Passport Number)： 西元 年 月 日Date:_____/_______/_______ (yy/mm/dd) (本人已確實瞭解本切結書所提之內容) (I have fully understood the contents stated in this declaration letter)
說明： 依據「僑生回國就學及輔導辦法」，所稱僑生，指海外出生連續居留迄今，或最近連續居留海外六年以上，並取得僑居地永久或長期居留證件回國就學之華裔學生。但就讀大學醫學、牙醫及中醫學系者，其連續居留年限為八年以上。 所稱海外，指大陸地區、香港及澳門以外之國家或地區；連續居留，指華裔學生每曆年在國內停留期間未逾一百二十日。連續居留海外採計期間之起迄年度非屬完整曆年者，以各該年度之採計期間內在國內停留期間未逾一百二十日予以認定。 Explanation： According to the "Measures for Overseas Students Returning to China for Study and Guidance", the term "overseas students" refers to Chinese students who have been born overseas and have lived continuously until now, or have recently stayed overseas for more than six consecutive years, and have obtained permanent or long-term residence certificates in the place of overseas residence to return to study in China. However, those who study in the departments of medicine, dentistry, and traditional Chinese medicine in universities should have a continuous residence period of more than eight years. The term "overseas" refers to countries or regions other than mainland China, Hong Kong, and Macau; "continuous residency" refers to the period during which Chinese students stay in China for less than 120 days per calendar year. If the period from the beginning to the end of the period of continuous stay abroad is not a complete calendar year, it must be acknowledged that the period of stay in China in the acquisition period each year does not exceed 120 days.

附表七 (Appendix 7)

7.華語文能力推薦函

Recommendation Letter Chinese Proficiency

致推薦人：

被推薦人目前申請就讀醒吾科技大學，感謝您撥冗填寫本推薦函，請詳實填寫本函，以利審核工作進行。如有需要，可自行增加版面，謝謝您的配合。

被推薦人姓名： (中文) (英文)

該生由民國 年 月 日起上課至 年 月 日止，

由本人教授 課程，每週上課 小時，學業總平均

分，使用教材為 。

該生之人品與在本人教授期間所表現之學習態度評定如下：(A為最好，D為最差)

學術研究潛能--------------A B C D (6) 入境隨俗(適應環境)-----A B C D

理解力-----------------------A B C D (7) 自信心----------------------A B C D

責任感-----------------------A B C D (8) 果斷力----------------------A B C D

獨立性-----------------------A B C D (9) 合群(與人和睦相處) ----A B C D

語言與寫作之表達能力--A B C D (10) 尊重他人文化-------------A B C D

華語文能力之評分：

聽力--------------------------A B C D (3) 閱讀-------------------------A B C D

普通會話--------------------A B C D (4) 寫作-------------------------A B C D

華語文能力之評分：

其他意見：

推薦人： 職稱：

服務單位： 電話/E-mail：

推薦人簽名： 日期： 地點：

如果我們有其他問題，可否與您聯絡? □是 □否

附表八 (Appendix 8)

8.自傳

Autobiography

申請人/Applicant：

請以中文或英文撰寫約300字，敘述個人背景、求學動機、求學期間之讀書計畫等，以及完成學業後之規劃。(如有需要，可續反面)

In the following space, please write a statement of about 300 words either in Chinese or in English stating your background, motivations, study plan, and career plan after completion of your studies (use both sides if needed).

附表九 (Appendix 9)

9.讀書計畫書

Study Plan

申請人/Applicant：

附表十 (Appendix 10)

10.外國學生申請入學推薦書

Recommendation Form Of International Student Admissions

致推薦人 To the referee:

被推薦人目前申請就讀醒吾科技大學，感謝您撥冗填寫本推薦書，請詳實填寫，以利審核工作進行。如有需要，可自行增加版面，謝謝您的配合。

This person is applying for admission to Hsing Wu University of Science and Technology. We would appreciate receiving your opinions regarding this applicant. Please feel free to add pages to make additional comments. We sincerely thank you for your time and effort.

被推薦人姓名/Name of Applicant：

1.您是何時認識被推薦人？你如何認識被推薦人？

How long have you known the applicant? How do you know him/her?

2.請敘述被推薦人的優缺點。What are the applicant’s strengths and weaknesses?

3.請評估被推薦人特質。Please rate the applicant on the qualities listed below.

傑出 Outstanding	優 Very Good	佳 Good	可 Average	差 Below Average	不宜評估 Unable to assess
理解能力Comprehension
分析能力 Analytical ability
創造力 Creativity
獨立性 Independence
成熟度 Maturity
合群 Collaborative skills
語言能力 Language skills

4.其他推薦事項。Other recommendations:

推薦人簽名 Referee’s Signature： 職稱 Position：

服務單位 Institution： 電話 Tel/E-mail：

日期/Date： 地址/Address：

 如果我們有其他問題，可否與您聯絡？

May we contact you if we have additional questions? □是 Yes □否 No

 請將此表格放入信封，並於彌封處簽章。

Please enclose this form in an envelope and sign your name over the flap of the sealed envelope