112學年度學位服登記借用 Cap and Gown Rental

112學年度申請學位服借用者，請填寫以下表單，如有問題，請先上網瀏覽借用注意事項，或請致電分機2376方小姐，謝謝。

Please fill in the following form for renting the cap and gown for Fall 2023. If there's any question, please dial extension 2376 for Ms. Fang.

院系所/單位 College/ Department/ Institute:

*借用代表人/借用人 Representative's Name/ Renter's Name:

*身分別 Identities:

學生 Student 教師 Faculty 行政人員 Administrative Staff

*連絡電話 Telephone No.:

*Ｅ-mail:

*學位服款式 Types of Academic Gown:

博士服 Doctoral Gown 碩士服 Master's Gown 學士服 Bachelor's Gown 其他組合 Combination

*學位服件數 Requested Pieces in total:

*各尺寸件數 Requested Pieces in Size:

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學碩士服請由左到右填入XL-L-M-S 件數，例如借用XL 2件、L 1件、M 3件及S 5件，請於欄位中依序填寫2-1-3-5。

When filling in the sizes for Master's and Bachelor's gowns, please follow the order XL-L-M-S from the left-hand to the right-hand column. For example, please fill in 2-1-3-5 if you would like to rent 2 pieces of XL, 1 piece of L, 3 pieces of M, and 5 pieces of S. （尺寸Sizes：XL: 175cm or above, L: 174 ~ 168cm, M: 167 ~ 162cm, S: under 161cm.）

博士服僅分L及M，請由左到右填入件數，例如借用L 2件、M 1件，請於欄位中依序填寫0-2-1-0。

Doctoral Gown offers L and M sizes only. When filling in the renting pieces of each size, please follow the order L-M from the left-hand to the right-hand column.

For example, please fill in 0-2-1-0 if you would like to rent 2 pieces of L & 1 piece of M. （尺寸Sizes：L: 160cm or above，M：under 160cm）

*預定取件日 Estimated Date of Pick-up:

(格式為西元年/月/日(YYYY/MM/DD 並自備紙箱或大袋子)

Fill in Year/ Month/ Day. Box or bag shall be prepared by the renter.

*預定取件時間 Estimated Time of Pick-up:

上午0900-1200 / 9:00-12:00 a.m. 下午1400-1600 / 2:00-4:00 p.m.

合計繳費金額(元) Total Amount of Payment (NT Dollars):

博士服400元/件、碩士服250元/件、學士服200元/件。

Rental fee for each piece：

Doctor’s: NT$ 400.

Master’s: NT$ 250.

Bachelor’s: NT$ 200.

已完成繳費 Payment Completed:

是 Yes 否 No 準備繳納 Ready to Pay

小提醒:需繳納完畢，才能拿取學位服。

Notice: the receipt of payment is required when picking up the gowns.

借用清單 Application Form:

請附加電子檔並於領取衣服時繳交申請單紙本 (博士袍申請單、學碩士袍申請單)，謝謝。

Please submit the application form (Doctoral、Master's & Bachelor's) when picking up the academic gown. Please also submit a printed copy.

其他 Others:

實際借、歸還情形 Record of Rental and Return:

由資產組填寫

Filled in by Property Management Division, NSYSU.

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