Name

Class

Student No.

Room No.

Building       No.

Reason

□Private Affairs  □Sick   □Public Affairs

The Content of Application for Leaving：

The Reasons of Leaving：

Date：From ____(year)___(month)___(day) to ____(year)___(month)___(day)  

Total____ day(s)

（Pay Attention to Your Safety During Leaving）

Signature:

Date: ____(year)____(month)____(day)

1、 The opinion of public activity teacher：

The opinion of public activity leader:

The signature of public activity teacher：

The signature of public activity leader (seal)：

2、 The opinion of the headteacher:

The signature of the headteacher：

3、 The opinion of the dean of International Education College：

The signature of the dean of International Education College (seal)：

4、 The opinion of the officer of International Office：

The signature of the officer of International Office (seal)：

5、The opinion of the main leader of the university：

The signature of the main leader of the university：