教育部补助高级中等学校接待国际学生经费申请表

1、附件一 Attachment 1教育部補助高級中等學校接待國際學生經費申請表Budget Application Form - Subsidies from the Ministry of Education for Senior High Schools Hosting International Students學校名稱School Name學校特色Characteristics of School第二外語課程種類Second Language Taught是否曾經接待國際學生Have you ever hosted an international student?是，國家/人數 Yes

2、, nationality of the students/ number of the students 否 No期望接待之國家Nationality of the expected students 人數Number of the expected students 接待計畫摘要Project Summary實施時間Time of Implementation課程設計Curriculum Design住宿之安排Accommodation 接待家庭（請填寫附件二接待家庭背景資料表） Host family (Please fill in a attachment 2- Host Family

3、 Information)學校宿舍（請填下列表格） School dormitory (Please complete the list below)住宿之床位數Number of students to host 宿舍管理者姓名Dormitory Manager房間數Number of rooms幾人/間Students/room價位Rate宿舍管理者電話Phone number of the manager管理者電子郵件E-mail of the manager是否提供三餐3 meals預算Budget1.計畫所需總經費新臺幣 元Total budget of the project NT

4、D 2.向教育部申請補助新臺幣 元Applying for Subsidies from the Ministry of Education NTD 學校承辦人Contact person職稱Title聯絡電話Contact number傳真號碼Fax numberE-mail附註：請另附詳細接待計畫書 PS. Please attach a project report in detail附件二 Attachment 2接待家庭背景資料表Homestay Background Information 家長姓名Names of parents or legal guardians年齡Age教育

5、程度Education語言能力Language skills English 英語 Japanese 日語 French 法語 Other 其他現住地址Address職業Occupation任職單位Company職務Position任職地址Work Address電話Telephone住宅 (H) 手機 (C)家庭成員及房舍狀況Familymembers&HousingFacilities稱 謂Family Member姓 名Name年 齡Age教育程度Education職 業Career 接待家庭至學校交通工具Transportation to school Walking 徒步 M

6、otorcycle 機車 Car 汽車 Bus 公車 Subway 捷運 Other 其他 （可複選）住宅型式Housing style Townhouse 獨棟 Mansion 華廈 Apartment 公寓 Other 其他是否自宅Do you own your house?屋齡Age of the house住宅坪數及房間數Square footage & number of rooms是否預備個人房間Does the student has to share a room Yes 是 No 否 Year 年 Feet 坪 Rooms 間 Yes 是 No 否接待意願及期間Dur

7、ation of host period附件三 Attachment 3Budget Estimate Form for Receiving International High School Students辦理接待國際高級中等學校學生經費概算表Name of School【學校單位全銜】 Year年 Month月 Date日 1. Source of budget 經費來源：Subject科目名稱Amount金額Remarks備註Funds raising自籌Apply for subsidy擬申請本專案補助Total合計2. Budget Items 各項費用概算Subject & Purpose科目名稱及用途別Unit單 位Quantity數 量Price單 價Budget Amount預算數Stat