Application form for short leave - TIGP--Bioinformatics Program

websterhissBiotechnology

Oct 1, 2013 (4 years and 13 days ago)

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Taiwan

International Graduate Program


Bioinformatics Program

Student Short
-
Leave


Student Name:

_____________________
_______


Student ID(ARC):

_______________________
___


Lab
Location
:

_________________________
_____


Reason for leaving:

_________________
_______________
___________________



Do you plan to go out of Taiwan:


Yes
(Dest
ination: __________________
__
_____
)




No


Contact information:


Email:

___________________________________

Phone no.:

_______________________________
_

Mailing address:

______________________________


Duration of le
aving: From: ________________
___
_
(MM/DD/YY)

To:

________________
____
(MM/DD/YY)


Total
(
___________
)

days



Student Signa
ture: _________________
__________
Date: _________________
_

(MM/DD/YY)


ARC

expiry date
: ____________________
(MM/DD/YY)


R
e
marks:

1. Please return the completed form to the BP Office once your leave has been
approved by the advisor. Failure to comply with the regulation may result in
termination of your fellowship
.

2. If the leaving duration is more than 14 days, the fellow
ship will be temporarily
suspended until you return.



Lab Advisor Approval

__________________________


B
ioInfo.
Program Coordinator Approval

__________________________