【表格】畢業生個人資料使用授權說明(離校手續用)

填寫「畢業生個人資料使用授權說明」前請先參考填寫範例，並請注意以下幾點：
1.項目二之授權使用項目同意請打ｖ，不同意請打ｘ。
2.立同意書人處之姓名請親簽或電子簽名(不接受打字、貼截圖/照片)。
3.上傳後請確定檔案（檔案格式建議為jpg或pdf檔)上傳成功。
4.立同意書人處之日期：年為114年〇月〇日。
4.其它未通過原因請參考未通過原因(上傳錯誤檔案等)。

以上資料不齊者，則視為未通過離校手續審查。
填寫後，請可翻拍同意書(JPG檔)或電子簽名(PDF檔)並上傳至校務資訊系統（路徑為：進入系統後點選「查詢」→「教務資訊查詢」→「離校審核查詢」進入作業系統。）

【113學年度第2學期辦理線上離校手續期間為：114年6月2日至114年8月7日】
【如有其他疑問，請洽電082-313741，謝謝】
 
 

Before filling out the “Graduate Personal Data Usage Authorization Statement,” please refer to the sample form and note the following points:

  1. For item 2 (Authorization Items), please mark ✓ if you agree or ✗ if you do not agree.

  2. The signer’s name must be signed by hand or by electronic signature (typing or pasting screenshots/photos is not accepted).

  3. After uploading, please confirm the file (recommended formats: JPG or PDF) has been successfully uploaded.

  4. The date on the authorization form should be written as Year 114, Month __, Day __.

  5. For other reasons for rejection, please refer to the “Reasons for Rejection” (e.g., uploading incorrect files).

Incomplete submissions will be considered as failing the graduation clearance review.

After completing the form, please photograph the signed authorization (JPG) or save the electronic signature (PDF) and upload it to the School Affairs Information System at:
[After logging in, click “Inquiry” → “Academic Information Inquiry” → “Graduation Clearance Inquiry” to access the system.]

The online graduation clearance period for the 2nd semester of academic year 113 is from June 2, 2025 to August 7, 2025.
If you have any questions, please call 082-313741. Thank you!