1.實習前【實習生填寫】-學生實習申請表–空白

國立高雄科技大學水圈學院水產科技產業博士班

Ph.D. Program of Aquatic Science and Technology, College of Hydrosphere Science, National Kaohsiung University of Science and Technology

學生修讀主題式產業實習申請書

Student apply for Industrial theme type practice form

【實習生填寫Student fil in

申請實習學生資料Personal data

學生姓名

Student name

申請日期

Apply date

             

        year       month      day

   

Student NO

聯絡電話

Mobile phone

身份證字號

Passport and ARC NO

出生年月日

Date of birth

             

        year       month      day

修讀課程名稱

Choose the name of internship course

主題式產業實習(一)必修

Required: Industrial theme type practice (1)

主題式產業實習(二)選修

Elective: Industrial theme type practice (2)

□主題式產業實習(三)選修

Elective: Industrial theme type practice (3)

(請勾選Please tick

E-mail

實習單位資料Internship agency

實習機構名稱

Internship agency name

實習機構地址

Address of internship agency

       

Mobile phone / Telephone

實習項目內容

Internship description

Internship period

Student signatures

研究生實習同意書

Postgraduate Internship Consent

本人同意自         日至         日期間為修讀 主題式產業實習(一)主題式產業實習(二)主題式產業實習(三)課程                         實習,

以完成實習課程規範之實習時數。參與實習期間願配合實習單位指導教師及本校輔導教師之教導,並遵守實習單位之保密等相關規定,如有違規事件,願接受校規及相關法規之處理,本人絕無異議。

I agree that during the internship period choose to study the industrial theme type practice course, go to an internship agency to intern. In the internship period willing to be subject with the industrial mentor and internship guidance teacher to teach, and comply with internship agency confidentiality, if have the violation, willing to accept dispose of, and no objection will be raised.

此致 國立高雄科技大學To National Kaohsiung University of Science and Technology

實習學生:                 簽章Student signatures

中華民國  111          (year / month / day)

Result

符合       不符合 研究生論文之研究主題

通過Approve  不通過Unapproved

指導教授簽章Advisor signatures

院長簽章Dean signatures