申請表 BOLETIM
APPLICATION FORM
認可課程蓋章 AVERBAMENTO DO RECONHECIMENTO DO PROGRAMA
PROGRAMME RECOGNITION
UNIVERSIDADE DE MACAU
UNIVERSITY OF MACAU
認可課程蓋章每份費用為澳門幣 55 元（以外幣支票付款另加銀行費用**）
MOP55 por Averbamento.
(Despesas adicionais sobre cheques emitidos fora de Macau**)
MOP55 per programme recognition.
(Additional bank charges are required for foreign cheque payments **)
姓名 Nome Name:
學號 N.° de Estudante Student No.:
□-□□-□□□□-□
學術單位 Unidade Académica Academic Unit:
FAH
FBA
FED
FHS
FLL
FSS
FST
HC
ICMS
畢業證書編號 N.° da Carta de Curso Certificate No.:
電話 Telefone N.° Telephone No.:
 本人確定於申請表中所提供的資料正確無誤，並聲明已知悉及明白《澳門大學/澳門大學註冊處收集個人資料聲明》。
 Declaro que as informações fornecidas neste boletim de requerimento são correctas, e que tomei conhecimento e compreendo a
Declaração sobre Recolha de Dados Pessoais da Universidade de Macau / Secretaria da Universidade de Macau.
 I declare that the information provided in this application form is correct and I have acknowledged and understood the <Personal Data
Collection Statement of the University of Macau/the Registry of the University of Macau>.
日期 Data Date:
申請人簽名 Assinatura do Requerente Applicant’s Signature:
=========================================================================================
FOR OFFICE USE ONLY
Treasury
Signature & Stamp
Registry Stamp
COMPLETED BY TREASURY SECTION
收 據 RECIBO RECEIPT
茲收到學生
學號
O pagamento de MOP/HK$
交來澳門幣/港幣
para o pedido de Averbamento pelo/a Sr.(a)
Estudante N.°:
.
Payment of MOP/HK$
for programme recognition from Mr. /Ms.
student no.:
日期 Data Date:
元作為辦理認可課程蓋章之費用。
,
,
received.
/
/
附註：請於三個工作天後攜同此存根前來領取。
Nota: É favor de apresentar este talão para o levantamento após 3 dias úteis.
Note: Please bring along with you this receipt for collection after 3 working days.
=========================================================================================
FOR TREASURY SECTION USE ONLY
Payment of MOP/HK$
for programme recognition from Mr. /Ms.
student no.:
日期 Data Date:
**
,
received.
/
/
Signature & Stamp of Treasury Section:
發票銀行
貨幣/本票
銀行費用
Lugar do Banco Emissor
Place of Issuing Bank
Moeda/ Cheque
Currency / Cheque
Despesas Bancárias
Bank Charges
澳門
港幣
Macau
Macao
Dólar Hong Kong
Hong Kong Dollar
-------------------
澳門或澳門地區以外
外幣
Macau ou Fora de Macau
Macao or Outside Macao
Moeda Estrangeira
Foreign Currency
澳門幣伍拾元
MOP50
REG/Form/012
Updated on 25/02/2014