元智大學教職員國外出差申請單

^{申請日期：
年月日}

姓名		所屬單位			職　稱			請假日期	自　　～　　，共　天
出國目的 (請勾選)	參加國際會議發表論文	會議名稱
		會議日期	自　　～　　，共　天			主辦單位／國家／地點				/ /
		論文名稱
	國際交流	目的地				出訪成員		□個別□團體　　　　　　人 (註：團體出差，主辦單位須先將計畫書呈校長核定)
		洽公期間	自　　～　　，共　天			訪問對象與預期成效
經費補助來源 (請勾選) 備註	國科會	□ 向國科會申請中，尚未核定補助與否。□ 已向國科會申請，但國科會不予補助。 □ 國科會已核定(專題/專案)，補助總經費　　　　　　元。國科會補助文號或計劃編號：
	校內	補助單位		預算編號	計畫名稱		補助金額


	校外 (請檢附校外單位核定函影本)	補助單位		預算編號	計畫名稱		補助金額


	預計支用之行政費：□報名費□註冊費□其他　　　　　　，申請金額：　　　　　　　　　　　　　　　　　　(請註明幣別)

申請人

職務代理人

單位主管

學院院長

補助經費

單位

全球事務處

(非國際交流毋須會簽)

研發處

人事室

秘書室

校長

日期：

註：依據「元智大學教職員工出差旅費報支規定」，請於返國後請將相關單據訂於黏存單上，檢附本申請表辦理核銷。

HO-CP-13-CF02(1.6版)/112.07.04 修訂

YZU Application Form for Faculty/Staff Going on Business Trip Abroad

^{Application
Date:}

Name		Service Unit			Job Title			Period of leaving	From to , _____days
Purpose of leaving (please check)	Attending international conference for publishing dissertation	Conference
		Period	From to _____days			Host／country／location				/ /
		Title of dissertation
	Dealing with affairs related to international academic cooperation	Destination				Delegation Members		□individual □Number of people on business trip　　　　　　 (For group business trips, the organizing unit must first submit the project proposal to the President for approval.)
		Period	From to _____days			The object to deal with and the goal to reach
Source of funds (please check)	National Science Council	During the application process and hasn’t been verified yet. □ The application has been rejected. □ The application has been verified with the funds of NT$_________________ Plan No.:_________________
	In-school	Funding unit		Budget No.	Name of plan		Funding amount


	Out-of-school (Please attach the copies of verified documents from out-of-school funding unit.)	Funding unit		Budget No.	Name of plan		Funding amount


	Estimated administrative expenses to be used：□registration fee □other:_________，Application amount:_________ (Please specify the currency.)

Applicant	Deputy	Office Director	College Dean	Funding Unit	Global Affairs Office (Non-international academic cooperation do not require approval)	R & D Office	Personnel Office	Secretariat Office	President

Date:

Note: Please submit the application form with relevant required documents upon returning to the country and submit it together with this application form for reimbursement with ‘YZU Regulations for Faculty Reporting Business Trip Reimbursement’.

元智大學教職員工國外出差申請表

YZU Application Form for Faculty/Staff Going on Business Trip Abroad