1、中山大學(xué)本科生退出交換申請(qǐng)表APPLICATION FORM FOR WITHDRAWAL FROM EXCHANGE PROGRAMMEv 申請(qǐng)退出香港或國(guó)外項(xiàng)目必須用中文和英文填寫。v Fill in the form in Chinese and English if withdrawing from programmes in HK or foreign countries.我在此申請(qǐng)放棄中山大學(xué)與_的交換機(jī)會(huì)。同時(shí)，本人亦了解這對(duì)兩校友好合作、項(xiàng)目的長(zhǎng)期發(fā)展及校內(nèi)學(xué)習(xí)資源管理所帶來(lái)的負(fù)面影響，并愿意承擔(dān)相應(yīng)后果。I hereby apply to withdraw from the

2、exchange programme between Sun Yat-sen University and _. I understood that such a decision would bring negative impacts on the intercollegiate cooperation, the healthy development of exchange programmes and the utilization of academic resources of the two universities and I am willing to take on the

3、 responsibility for the consequences caused by my decision. 我的個(gè)人情況如下My personal particulars are listed below: 姓名：院(系):Name in Pinyin：School (Department):專業(yè)：學(xué)號(hào)Student ID No.:Major:電話Tel. No.:電子郵件E-mail address:退出交換生項(xiàng)目的原因（請(qǐng)?jiān)谥匾脑蚝蟠颉啊保㏑easons for the withdrawal (Please put a “” next to appropriate reas

4、on(s) listed below):健康原因經(jīng)濟(jì)原因 Health reason Financial reason個(gè)人原因課程原因 Personal reason Course reason 請(qǐng)用中文陳述詳細(xì)原由Please specify the reasons in details in Chinese: 請(qǐng)用英文陳述詳細(xì)原由（如需要）Please specify the reasons in details in English (if required):學(xué)生簽名：Sign of Student：院（系）審查意見(jiàn)：教務(wù)處審核意見(jiàn)：Opinion of Department:Opinion of University Deans Office: 主管教學(xué)領(lǐng)導(dǎo)簽名 （院、系公章） 簽名 (教務(wù)公章) Signature (Officia