朝陽科技大學 學生轉系、所申請表 
Chaoyang University of Technology Application for Department Transfer
姓名Name	學號Student No.	申請日期Date (MM/DD/YYYY)	
□日間部 Daytime Division
□進修部 Evening Division	□ 本國生 Local Student	□ 外國學生 Foreign Student    □新南向產專班 Industry-Academia Collaboration Program
□ 陸生 Mainland Student	□ 僑生、港澳生 Overseas Chinese/Hong Kong/Macau Student	
原屬系級(本學期) 
Current Dept.	□	四技 Bachelor Program
□	碩士 Master Program	系 Dept.	
年級 Year	班 Class 		
志願序 Order of Preference	□	第一志願 1st Choice	□第二志願 2nd Choice	
擬轉入系級(下學期) Intended Transfer-in Dept.	□	四技 Bachelor Program
□	碩士 Master Program	系 Dept.	
年級 Year	班 Class 		
	□	平轉 Normal Transfer	□自願降轉 Demoting Transfer	
申請原因 Reason(s) for Major Change	附繳資料 Documents Attached
□	歷年成績單 Official Transcripts (Not required for Freshman & Transfer)
□	各系(所)規定資料 Required documents from Dept.
□	語言能力.財力證明文件(僅新南向產專班須檢附)
Language Proficiency and Financial Proof (For Industry-Academia Collaboration Program only)	
學生簽章 Signature of Applicant	電話 Mobile	
家長簽章 Signature of Parent	家長電話 Parent’s Mobile	

(日間部大學部學生必須家長簽章)Daytime undergraduate students must obtain a parent’s signature	
審核意見 Review by	

原屬導師
Current Tutor	□	同意轉出 Agree	□ 不同意轉出 Disagree 
□	請學生與學生發展暨特殊教育資源中心面談(T1-106) 
Student is requested to have an interview with the Student Development and Special Education Resource Center.
□	請新南向產專班生與轉入系面談，評估語言能力、學分抵免及課程規劃等相關事項，以順利銜接課程。
The Industry-Academia Collaboration Program student is requested to have an interview with the Intended Department to assess language, credit transfer, and course planning for a smooth transition.
(簽章 Signature)	
原屬系主任
Current Dept. Chair	(簽章 Signature)	
學生發展暨特殊教育資源中心
Student Development and Special Education Resource Center	(簽章 Signature)	
轉入系 Intended Dept.	 (簽章 Signature)	
檢附轉入學系(所)要求之資料併同申請表送交至教務處註冊組。
Please submit application together with attached documents to the Admissions Section.	

轉入系主任
Dept. Chair	□ 符合本系(所)轉入標準，同意轉入。Meet Dept. standards or passed the interview; Approved.
□ 學業成績目前未符合標準，若計入本學期學業/操行成績達      分通過，同意轉入。
Academic performance currently does not meet the standards. If this semester's academic/conduct grades reach            . ; Approved.   
□ 不符合本系(所)轉入標準，不同意轉入。(請務必簡述原因)Does not meet standards; Not approved. (Reason:              )
□ 其它。Other.
(簽章 Signature)	
註冊組
Admissions Section	1.是否符合轉系、所名額及相關規定。 Fulfill transfer quota and related regulations.                 □是Yes □否No
2.新南向產專班生是否符合轉系、所名額及相關規定。
The Industry-Academia Collaboration Program student fulfill transfer quota and related regulations.  □是Yes □否No

(承辦人簽章)Handled by:                       (主任簽章)Director's Signature:	
註 Notes	
1.	平轉：一年級轉二年級或二年級轉三年級。自願降轉：目前二年級升三年級自願降轉為二年級或三年級升四年級自願降轉為三年級。
Normal Transfer refers to transfer from Year 1 to Year 2 or from Year 2 to Year 3. Demoting Transfer refers to transfer from Year 2 to Year 2 or from Year 3 to Year 3.
2.	學生申請轉系(所)前應深入瞭解擬轉入系(所)課程內容，所修學分及其特性。
Student should understand the course contents, credits, characteristics and transfer requirements of the department they intend to transfer before application.
3.	轉系(所)申請期限依本校行事曆規定期限內提出申請，逾期不予受理。
Applications must be submitted within the deadline specified in the CYUT academic calendar. Late submissions will not be accepted.