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1、1 中國醫藥大學外國學生入學申請具結書 Declaration Form for International Students China Medical University 報考系所別 Department/Institute Applied 1. 2. 3. 姓名Full Name 中文(in Chinese) 英文(in English) 一、 本人保證符合中華民國教育部外國學生來臺就學辦法之規定。 I hereby certify that I conform with the requirements indicated in the “Regulations for foreig
2、n students studying in Taiwan” issued by the Ministry of Education of ROC. 二、 本人了解中華民國國籍法第二條之認定。 I hereby certify that I understand Article 2 ofNationality Act. 國籍法第二條所認定：有下列各款情形之一，屬中華民國國籍： 一、 出生時父或母為中華民國國民。 二、 出生於父或母死亡後，其父或母死亡時為中華民國國民。 三、 出生於中華民國領域內，父母均無可考，或均無國籍者。 四、 歸化者。 ROC nationality mentioned
3、above is defined in accordance with Article 2 ofNationality Act: A person shall have the nationality of the ROC under any of the conditions provided by the following Subparagraphs: 1. His/her father or mother was a national of the ROC when he/she was born. 2. He/she was born after the death of his/h
4、er father or mother, and his/her father or mother was a national of the ROC at the time of death. 3. He/she was born in the territory of the ROC, and his/her parents cant be ascertained or both were stateless persons. 4. He/she has undergone the naturalization process. 三、 本人保證符合以下五項其中之一： I hereby ce
5、rtify that I qualify for one of the following three conditions: (1) 具外國國籍且未曾具有中華民國國籍，於申請時並不具僑生資格 At the time of application, I am holding a foreign nationality, and I am not an overseas compatriot student, nor had I ever possessed ROC nationality. (2) 具外國國籍及兼具中華民國國籍者，自始未曾在臺設有戶籍，並於申請時已連續居留海外六年以上者 （擬申
6、請就讀大學醫學、牙醫、中醫學系或學士後中醫學系須連續居留八年以上），且未曾以僑生身 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。 At the time of application, I am holding a foreign nationality and ROC nationality, but have never had a household registration in Taiwan, and have been living in a foreign country continuously for at least 6 consecutive years (at
7、 least 8 consecutive years for applying for School of Medicine, School of Dentistry, School of Chinese Medicine and School of Post- Baccalaureate Chinese Medicine), and have not studied under the status of overseas Chinese students nor received placement permission during the same year of the applic
8、ation by the University Entrance Committee for Overseas Chinese Students. (3) 具外國國籍，曾兼具中華民國國籍者，於申請時已經內政部許可喪失中華民國國籍已滿八年，並於申 請時已連續居留海外六年以上者（擬申請就讀大學醫學、牙醫、中醫學系或學士後中醫學系須連續居 留八年以上），且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至台灣大 學院校。 At the time of application, I am holding a foreign nationality and once had ROC na
9、tionality, and have obtained documents issued by Ministry of Interior indicating that I have given up ROC nationality for at least 8 years, and have been living in a foreign country continuously for at least 6 consecutive years (at least 8 consecutive years for applying for School of Medicine, Schoo
10、l of Dentistry, School of Chinese Medicine and School of Post-Baccalaureate Chinese Medicine), and have not studied under the status of overseas Chinese student nor received placement permission during the same year of the application by the University Entrance Committee for Overseas Chinese Student
11、s. (4) 具外國國籍，兼具香港或澳門永久居留資格，且未曾在臺設有戶籍，申請時於香港、澳門或海外連續 居留滿六年以上者(擬就讀本校醫學、牙醫、中醫學系或學士後中醫學系，須連續居留年限為八年以 上) (Continued on next page 接下頁) 2 At the time of application, I am holding a foreign nationality and a permanent residence status in Hong Kong or Macao, having no history of a household registration reco
12、rd in Taiwan and, at the time of application, has resided in Hong Kong, Macao, or another foreign country for at least 6 consecutive years (at least 8 consecutive years for applying for School of Medicine, School of Dentistry, School of Chinese Medicine and School of Post-Baccalaureate Chinese Medic
13、ine) (5) 曾為大陸地區人民具外國國籍且未曾在臺設有戶籍，申請時已連續居留海外六年以上者，得依本規定 申請入學。(擬就讀本校醫學、牙醫、中醫學系或學士後中醫學系，其連續居留年限為八年以上) At the time of application, I am a former citizen of Mainland China and hold a foreign nationality, having no history of household registration record in Taiwan, and at the time of application, have res
14、ided overseas continuously for at least 6 consecutive years is qualified to apply for admission under these regulations. (at least 8 consecutive years for applying to School of Medicine, School of Dentistry and School of Chinese Medicine) 四、 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
15、，經查屬實即取消入學資格，且不發給任何有關之學分證明 All the documents I have provided (including diploma, passport, and other relevant documents whether original or copy) are legal and valid documents. Should any of the documents be found to be altered or to violate any university regulation, I will lose my CMU admission pr
16、ivilege and no proof of attendance or credits completed will be issued by the University. 五、 本人所提供之最高學歷證明(申請大學部者提出高中畢業證書、申請碩士班者提出大學畢業證書、申請博 士班者提出碩士畢業證書)，在畢業學校所在地國家均為合法有效取得畢業資格，並所持有之證件相當於 中華民國國內之各級合法學校授予之相當學位，如有不實或不符規定或變造之情事，經查屬實即取消入 學資格，並註銷學籍，且不發給任何有關之學分證明或畢業證書。 The proof of the highest level of education attained that I have provided (for bachelors degree applicants -your high school diploma; for master
