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  • Leave of Absence or Voluntary Withdrawal Request Form Semester: ______ / Academic Year: __________ Fu Jen Catholic University □ Leave of Absence (□ one academic year / □ one semester) □ Reasons for Voluntary Withdrawal: __________ □ Day Division □ SOCE: College of ____________ Department (Program) _____________ Section ______ Academic Level: _________ Student’s ID Number: Student’s Name: Sex:□ Male □ Female Student’s Address: Telephone: Parent or Guardian: Address: Status:□ All other students  □ Overseas Chinese Student, Student from Mainland, Student with Parents as Diplomatic Personnel for the Government, and Repatriated Mongolian and Tibetan Student □ International Student □ Student with physical or mental challenges I. After filling out the personal information, students can proceed with the application upon the approval of their parent or legal guardian. (The following students can leave the signature of parent/guardian empty: graduate students, students of the Post-baccalaureate Department of Law, and students of the two-year in-service program in the Department of Nursing) Procedure for Application Student's Signature Parent/Guardian Signature Department Mentor Comments Department or Program Office Comments or Seal With the consent of their parents or legal guardians, undergraduates may apply for a leave of absence or a voluntary withdrawal in accordance with the regulations in Articles 33 and 36, Chapter 8, of the University Academic Policies. (Applicable for leave of absence, voluntary withdrawal, and transfer to another university) The department mentor is advised to complete at the Mentor Counseling System the counseling records of the student leaving the school. This measure will help with transition of the mentoring task when the student returns to school. Campus Ministry at Individual Colleges For Day Division students- For students of the Colleges of Liberal Arts and Education: R101, the Liberal Enlightenment Hall For students of the Colleges of Arts and Communication: R 112, the College of Arts Building For students of the College of Foreign Languages and Literature: R111, the Foreign Languages Building For students of the College of Science and Engineering: R 134, the Divine Word Academic Highrise For students of the College of Human Ecology: R005, College of Human Ecology Building For students of the School of Law, and the Colleges of Management and Social Sciences: R112, Xavier Hall For students of the College of Medicine: R147, Cardinal Shan Medical Building For SOCE students- ES 109, the School of Continuing Education Building (Applicable to students leaving school due to family issues, job related issues, and economic reasons) Comments from Department Chair/Program Director Comments from College Dean (or Division Director) Submitting Application to the Registrar For Day Division students: YP 209 (2nd floor), Yehsheng Administration Building For SOCE students: ES201 (2nd floor), the School of Continuing Education Building II. After applying for the leave of absence or voluntary withdrawal at the Registrar, students can proceed further at the other offices. Once students return this form to the Registrar, within seven days since the submission of the application (holidays included), both the application and the procedure for leaving school can be considered complete. Procedure for Leaving the University Student Life Division Group Insurance Tuition Waivers Student Loans Military Service Resource Center For Day Division students: YP 104 (1st floor) at the Yehsheng Administration Building For SOCE students: ES201 (2nd floor) at the School of Continuing Education Building For Day Division students: YP 104 (1st floor) at the Yehsheng Administration Building For SOCE students: ES201 (2nd floor) at the School of Continuing Education Building For Day Division students: YP 104 (1st floor) at the Yehsheng Administration Building For SOCE students: ES201 (2nd floor) at the School of Continuing Education Building For Day Division students: YP 107 (1st floor) at the Yehsheng Administration Building For SOCE students: ES201 (2nd floor) at the School of Continuing Education Building Students with physical and mental challenges should go to MD 130 (1st floor) at the Cardinal Shan Building. Cashier Libraries Counseling Center for Overseas Chinese and Students from Mainland International Student Center For Day Division students: YP 1161 (1st floor) at the Yehsheng Administration Building For SOCE students: ES200 (2nd floor) at the School of Continuing Education Building All students can go to any of the following libraries: Kungpo Library, Fahy Library, or Cardinal Shan Library. □ Overseas Chinese Student □ Student from Mainland □ Student with Parents as Diplomatic Personnel for the Government □ Repatriated Mongolian and Tibetan Student Day Division students should go to A112 (1st floor) at the Cardinal Tien Memorial Hall. For Day Division students: A113 (1st floor) at the Cardinal Tien Memorial Hall For SOCE students: ES201 (2nd floor) at the School of Continuing Education Building Physical Education Office For all students: DG 105 at the old College of Medicine Building before 18:30, or the Facility Room in the Physical Education Office at Chung Mei Auditorium after 18:30 (Graduate students are exempt from this requirement.) Military Training Office For Day Division students: YP217 (2nd floor) at the Yehsheng Administrative Building For SOCE students: ES201 (2nd floor) at the School of Continuing Education Building (Graduate students are exempt from this requirement.) Registrar For Day Division students: YP209 (2nd floor) at the Yehsheng Administrative Building For SOCE students: ES201 (2nd floor) at the School of Continuing Education Building (Upon submission of this form, the application and the procedure for leaving school are considered complete.) Application for refund should follow the University Regulations for Refunds for Leave of Absence and Withdrawal. See website: http://www.ga.fju.edu.tw. Date of Leaving the University: Month ________ Date _________ Year _________
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1 FILENAME  DownloadSubLabelFileServlet 
2 FILETYPE  doc 
3 FILEDATE  2017/12/04 
4 FILETIME  14:10:24 
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7 TITLE  輔仁大學學生 離校申請單 
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10 SUBJECT   
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12 MANAGER   
13 COMPANY  輔仁大學教務處 
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