類別一國立中央大學物理學系上詮光纖獎學金申請表-補

1、(類別一)國立中央大學物理學系上詮光纖獎學金申請表-補助學生出國交流(category 1) national central university department of physics: foci scholarship application form for financial assistance for students studying abroad申請人姓名applicants name中文chinese name系所及年級department and year of study英文english name身份證字號(居留證號)id no(arc no)學號school n

2、umber聯(lián)絡電話telephone分機 手機extension cell電子郵件信箱email出國時間duration of stay overseas 自 年 月 日至 年 月 日from _year _ month _ day until _year _ month _ day地點(國、州、城市)destination (country, state/province/ city)研修或實驗計畫study or experiment plans邀請單位是否已補助費用has the inviting department already provided financial aid?否no

3、是 機票費_元生活費_元其他_元yes air fare_ntd living expenses _ntd other _ntd 有無向其他機構申請補助has the applicant applied for financial assistance from other departments?無 no有 機構名稱_ 金額_元 yes institute name: _ amount: _ntd欲申請補助項目及金額desired category of assistance and amount 機票費 _元air fare _ntd 生活費 _元 (說明：us$_/天 * _天 * 滙率

4、_)living expenses _ntd (explanation: us$ required per day times number of days spent abroad times current exchange rate) 其他 _元other _ntd合計： _元total: _ntd補助項目及金額(由審查委員會填寫)approved financial aid(for reviewers use only) 機票費 _元air fare _ntd 生活費 _元living expenses _ntd 其他 _元other _ntd合計： _元total: _ntd檢附文件

5、required documents 1. 邀請單位邀請函或證明文件invitation from the inviting group or other documents providing proof of invitation.2. 指導教授推薦函advisor recommendation letter3. 歷年成績單students grade transcripts4. 其他有助審查之資料any other documents that can assist in the review process. 獲同意補助者，於返國後須檢附相關核銷文件與出國報告書申請補助。those a

6、pproved for financial aid must provide a report and documents verifying their trip in order to receive said aid upon their return. 申 請 人：_日期 年 月 日name of applicant: _ date: _ year _ month _ day指導教授：_日期 年 月 日supervising professor: _ date: _ year _ month _ day 系主任批示：_日期 年 月 日department head: _ date: _

7、 year _ month _ day(類別二)國立中央大學物理學系上詮光纖獎學金申請表-補助學生出席國際會議(category 2) national central university department of physics: fiber optics scholarship application form for financial assistance for students attending overseas conferences申請人姓名applicants name中文 chinese系所及年級department and year of study英文 engli

8、sh身份證字號 id no學號student number 聯(lián)絡電話phone number分機 手機extension cell電子郵件信箱email出國時間duration of stay overseas自 年 月 日至 年 月 日from: _ year _ month _ dayuntil: _ year _ month _ day地點(國、州、城市)destination (country, province, city)會議正式名稱name of conference中文：chinese英文：english會議時間date and duration of conference自

9、年 月 日至 年 月 日from: _year _ month _ day until: _ year _ month _ day地點(國、州、城市)location (country, province, city)會議主辦單位name of department hosting conference中文：chinese英文：english擬 發(fā) 表論文題目students thesis topic中文：chinese英文：english大會排定論文發(fā)表方式 type of presentation： oral poster otherevent thesis issuing method:

10、 邀請單位是否已補助費用has the inviting department already provided financial aid?否no是 機票費_元生活費_元其他_元yes air fare_ntd living expenses _ntd other _ntd 有無向其他機構申請補助has the applicant applied for financial assistance from other departments?無 no有 機構名稱_ 金額_元 yes institute name: _ amount: _ntd欲申請補助項目及金額desired assista

11、nce category and amount 機票費 _元 air fare _ ntd 生活費 _元 (說明：us$_/天 * _天 * 滙率_)living expenses ntd (instructions: us$ total per day times days abroad times current exchange rate to ntd) 其他 _元other _ ntd合計： _元total: _ ntd補助項目及金額(由審查委員會填寫)financial aid granted(for reviewer use only) 機票費 _元air fare _ ntd 生

12、活費 _元living expenses _ ntd 其他 _元other _ ntd合計： _元total: _ ntd檢附文件required documents1. 國際會議主辦單位致申請人論文被接受之證明文件影本或本人之正式邀請函影本a photocopy of the letter of acceptance issued by the overseas conference hosting department of the applicants thesis or a photocopy of the personal invitation directed to said ap

13、plicant. 2. 擬發(fā)表之論文摘要及論文全文影本(論文以在國內完成而尚未發(fā)表者為限)a copy of the abstract and full text of the applicants thesis (required only if the thesis is already completed before the departure date but has not yet been published)3. 國際會議日程表、會議有關資料及其他有助審查之資料a calendar of events for the overseas conference in questio

14、n, and other applicable information or documents regarding said event that may assist the reviewer. 4. 指導教授推薦函advisor recommendation letter5. 歷年成績單students grade transcripts獲同意補助者，於返國後須檢附相關核銷文件與出國報告書申請補助。those approved for financial aid must provide a report and documents verifying their trip in ord

15、er to receive said aid upon their return. 申 請 人：_日期 年 月 日name of applicant: _ date: _ year _ month _ day指導教授：_日期 年 月 日supervising professor date: _ year _ month _ day 系主任批示：_日期 年 月 日department head 批示 date: _ year _ month _ day(類別三)國立中央大學物理學系上詮光纖獎學金申請表-研究傑出獎助(category 3) national central university

16、department of physics: fiber optics scholarship application form: research excellence award中文姓名chinese name學號student id no英文姓名english name指導教授姓名supervising professors name就讀系所年級department and year of studyemail聯(lián)絡方式contact information手機： 研究室分機： cell phone no: lab extension: 申請類別application category學士

17、班 碩士班 博士班bachelors degree masters degree, phd.研究發(fā)表期間research thesis publication period105學年度(105.08-106.07)2016academic year (2016/08-2017/07)本人保證所申請之研究成果皆為本人所著，如經查獲違反規(guī)定屬實，於七日內將所領取獎助學金繳回學校。i hereby guarantee that the research for which i am submitting this application is my own work; if after review

18、 it is discovered that this is not the case, i agree to return the awarded amount to the school within 7 days. 申請人： (簽名蓋章) signature or seal of applicant: 年 月 日 year month day系所審查意見：reviewers comments:系主任(所長)簽核： department heads signature:推薦順位：recommended ranking:l 論文統(tǒng)計：thesis statistics: 期刊論文著述統(tǒng)計（請

19、寫篇數(shù)）thesis publication statistics (please specify issue number)類 別type第一作者或通訊作者篇 數(shù)first author or corresponding authornumber of articles除指導老師外排序第1之篇數(shù)the most frequently published author other than the supervising professor.其他順位篇數(shù)other article ranking. sci、ssci期刊、a&hci期刊science citation index,social

20、sciences citation index publication, arts and humanities citation index publicationtssci各院明訂之其他期刊other special departmental publicationsimpact factor total第一作者或通訊作者之文章總和first author or corresponding authors total number of publications非第一作者或通訊作者之總和first or corresponding authors total number of publi

21、cations已接受並發(fā)表number of accepted and published articles共 篇total備註：如該期刊排名係依字母順序者而非因貢獻程度者，請?zhí)貏e註明申請人貢獻。期刊論文如文章排序比較後面者，請附上貢獻說明。note: please specify if the publication in question lists articles in alphabetical order instead of by impact factor ranking. for those articles lower in the list, please elaborat

22、e on what the main contribution of the research is. l 著作目錄（請將申請者名字以粗體表示）： index of authors (please indicate the applicants name in bold letters):各類著作請按發(fā)表時間先後順序填寫。每篇文章請依作者姓名（按原出版之次序）、出版年、月份、題目、期刊名稱、起迄頁數(shù)之順序填寫。please list the authors in the chronological order of their research being published. informa

23、tion for each article should be presented in the following order: author(s) names (in the order listed in the original publication), year and month of publication, research topic, name of the journal in which the article appeared, and on which page the article is published. 期刊論文thesis publicationno期

24、 刊 論 文thesis publicationimpact factor該期刊在wos所屬學科內之排名wos field ranking number of this issue. 1lin jy, chung sy, cheng fc (2002) effects of magnesium sulfate on energy metabolites and glutamate in the cortex during focal ischemia and reperfusion in the gerbil monitored by a dual-probe microdialysis te

25、chnique. life sciences 71:803-811. (sci)-範例12 (排名)12 (rank)50 (所屬學科總期刊數(shù))50 (total number of publications in this field)23表格不足請自行增列if there is not enough space in the above table, please add more lines as needed.l 檢附文件: documents to attach:1. 期刊論文全文the full text of the thesis as it appears in the jou

26、rnal publication.(申請表&期刊論文全文電子檔請email: .tw)(please email the application form and full text of the thesis to: .tw)2. 論文指導教授推薦函advisor recommendation letter (推薦函請密封，推薦人請於封口處簽名request your recommender to enclose the letter in the envelope, seal it, and write their signature a

27、cross the seal of the envelope.)l 申請者請簡述對論文貢獻內容please briefly describe the applicants contribution to the content of the paper申請人簽名： 指導老師簽核： signature of applicant signature of supervising professor(類別四)國立中央大學物理學系上詮光纖獎學金申請表-清寒優(yōu)秀學生獎助(category 4) national central university department of physics: fibe

28、r optics scholarship application form: award for excellent students in straitened circumstances申請日期:民國_年_月_日 申請人簽名: _date of application: _ year _ month _ day signature of applicant _ 申請人姓名applicants name系別department性別gender住宅電話home phone no:年級grade學號student id no手機號碼cell phone no:身份證字號national id n

29、oemail本學年度是否同時申請其他獎助學金 have you applied for any other scholarships this year? 否 no 是 yes ，獎助學金名稱: name of other scholarships本人保證不重覆領取其他獎助學金，如發(fā)現(xiàn)重覆領取，願意自動放棄且繳回。the applicant agrees not to apply for the same scholarship multiple times, and if it is discovered that they have received the same one multip

30、le times they agree to immediately return the money以上由申請人填寫the above must be filled out by the applicant. 老師推薦及說明teachers recommendations and explanation. 推薦人簽名signature : 須繳之文件：（以下由系所承辦員初核無誤後，在左方內打，申請人勿填）required documents: (once verified by the reviewer that each of these are correct, please check the box. official use only) 1. 申請表乙份（即本頁）。1