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
□ 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.	
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.
(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)	
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	□	通過，無須參考本學期成績，預計編入班級	班
Approved; current semester grades not required. Class to be assigned	.
□	須參考本學期成績後，決定是否通過轉系(所)。(成績須達	分通過)
Approval of the transfer will depend on this semester’s grades. (Passing Grade:   	)
□	不通過(請務必簡述原因) Not approved. (Reason:                               )

(簽章 Signature)	
註冊組
Admissions Section	□	符合轉系、所名額及相關規定 Fulfill transfer quota and related regulations.
□	不符合轉系、所資格 Fail to fulfill related transfer regulations.	
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.