浙江师范大学研究生留学生学籍异动申请表

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1、浙江师范大学研究生留学生学籍异动申请表StudentStatusChangeApplicationFormforInternationalGraduateStudentsofZJNU护照名PassportName:学号StudentIDNo.:性别Sex:入学时间DateofEnrollment:年/Yr.月/Mon.日/Day所在院College/Department:所学专业Major:护照号PassportNo.国籍Nationality:攻读类型：□硕士生(Master’sdegreestudent)□博

2、士生(Doctoraldegreestudent)费用类型：□中国政府奖学金(CSCScholarship)□孔子学院奖学金(CISScholarship)□自费(Self-Financed)□其他(Others)电话/Telephone：E-mail：异动类型：□休学(TemporaryAbsence)□自动退学(WithdrawfromSchool)□复学(ResumeSchooling)□学习延期(Extension)异动事由Reasons（Additionaldocumentsmaybeattached,

3、ifnecessary）:期限(Duration):年/Yr.月/Mon.日/Day至(To)年/Yr.月/Mon.日/Day.签字(Signature)：年/Yr.月/Mon.日/Day校医院防保科意见：（因病休学者必须）CampusHospital:(ForTemporaryAbsencebyillnessonly)签字(Signature)：公章(OfficialStamp)年/Yr.月/Mon.日/Day所在院系意见导师意见(Student’sSupervisor):签字(Signature)：年/Yr.

4、月/Mon.日/Day所在院系领导意见(Dean,Student’sCollege/Department):签字(Signature)：公章(OfficialStamp)年/Yr.月/Mon.日/Day研究生院意见负责人签字:(Director,GraduateSchool)公章(OfficialStamp)年/Yr.月/Mon.日/Day国际处意见负责人签字(Director,DivisionofInternationalExchangeandCollaboration)公章(OfficialStamp)年/Y

5、r.月/Mon.日/Day注：因病休、复、退学应附医院证明（女生生育应附已婚证明）。Medicalcertificateisrequiredtotemporaryabsence/resumeschooling(Amarriagecertificateisrequiredforladiesgivingbirthtoababy).每次延期时间只能申请一学期。Onesemesterextensionisacceptableforeachapplication。此表由国际处留办汇总交至档案馆存档。