国立成功大学国际学人短期多房间职务宿舍借住申请表.DOC

1、國立成功大學 國際學人短期多房間職務宿舍 借住申請表 National Cheng Kung University Application for work-related multi-room dormitory for overseas short time visitors 申請人 姓名 Applicant 到職日期 Report-for-duty Date 借 住 期 間 Period 自 年 月 日 From dd mm yy 至 年 月 日 To dd mm yy 身分證字號 ID NO. 申請日期 Date of Application 單 位 Unit 總積點數 Total P

2、erformance Points 職 稱 Job Title 電話 Tel 配偶、未成年子女、父母或身心障礙賴以扶養之已成年子女隨居任所者 Spouses, underage children, parents, or adult children with physical/mental disabilities who rely on the support of and live with the Applicant 稱謂 Title 姓名 Name 出生年月日 Date of Birth 身份證字號 ID NO. 本人確認無下列不得申請借用多房間職務宿舍情形之一 (本校宿舍配借及管理

3、要點第 4 點 )： I hereby confirm that I do not have the following situations; (Dormitory regulation “Rent and Management Clause 4“) 一、配偶及扶養親屬均未隨同居住。 1. Spouse and dependants are not with me. 二、本人、配偶或未成年子女在距離本校 2 0 公里範圍內有自有房屋。 2. I,my spouse or under age dependents have own resident place within 20 kilome

4、ters from university. 三、本人或配偶已獲政府輔助購置 (建 )住宅或貸款。 3. I or my spouse gets subsidy or loan from government to buy(construct) resident place. 四、配偶為軍公教人員，已借用政府機關首長宿舍或多房間職務宿舍。 4. Spouse is a military or government officer, and already rents dormitory which is for government officer or work-related. 若有不實，願

5、負相關法律責任 I hold my above statement as true, and I accept full legal responsibility. 申請人： Applicant : 年 月 日 Date : dd mm yy 證明文件 Document 戶籍謄本或戶口名簿、應聘資料、入境證明。 Domiciliary Register, Letter of appointment, Immigration proof 單位主管 Unit Supervisor 學院院長 Dean of Faculty 審查意見 Received by 國立成功大學國際學人短期 多房間職務宿舍配

6、借及 管理細則第 點規定辦理配借。 According to “National Cheng Kung University , work-related multiple rooms dormitory for oversea short time visitors regulation and management Clause _“, application is approved. 分配宿舍地址： 臺南市 路 巷 號 樓 Assigned dormitory address: Floor_, No._, Lane , Road, Tainan City. 承辦人： Clerk : 人事

7、單位 Personnel Department 總務長 Supervisor of General Affairs 資產管理組主管Supervisor of Property Management Division 校 長 President （本申請表一式兩份，一份資產管理組存查，一份申請人收執） There are two copies of this application form, one for Property Management Division, and one for applicant. 備註：奉准簽約進住後，須依規扣繳併入薪資內之房租津貼數額。 Remark: Aft

8、er moving in, the rent is deducted from the housing subsidy in salary package. 第 1 頁 /共 3 頁 國立成功大學國際學人短期 多房間職務宿舍配借及 管理細則 National Cheng Kung University Rent and Management Regulations for work-related multi- room dormitory for oversea short time visitors 103 年 04 月 09 日 102 學年度第 4 次校務會議修正通 Passed at

9、 the 4th Academic Affairs meeting , 04.09.2014 一、為加強自海外來校任教教師之服務，特提供短期多房間職務宿舍，依本校宿舍 配借及管理要點第十七點訂定本細則。 1. To emphasize services for oversea teachers, university provides short term multi-room dormitory, and sets up related regulations according to “Dormitory Rent and Management Regulations, Clause 17

10、“. 二、本宿舍 供 有眷外籍學者或有 眷旅外回國一年內延聘來校任教之教授、副教授、助理教授及具有博士學位之講師至多借住三學年（六個學期）之宿舍。但有特殊需要，且尚有空餘宿舍可供配借，經簽請校長核准者，得延長二年，並提宿舍配借及管理委員會 (以下簡稱委員會 )報告。 前項經延長二年期滿後，為禮遇特殊領域優秀人才 ，經由相關系所、學院主管推薦，教務長會簽意見， 經校長核准者，得延長三年，並提委員會報告，其數量不超過總戶數十分之一為限。 2. This dormitory is for married overseas scholars (professors, assistant profess

11、ors, associate professors and lecturers with Ph.D degree) or those who have returned to Taiwan to teach at school within 1 year.Maximum living period is 3 years (6 semesters).If there is any special case and there is space available, and applicant gets approval from the President, living period can

12、be extended for 2 more years. Applicant should report to “Dormitory Rent and Management Committee“ as well. After 2 more years, in order to serve outstanding persons in special fields, living period may be extended for 3 more years after getting recommendation from supervisor of department, faculty,

13、 and getting approval of Officer of Academic Affairs and the President. Application should be reported to Dormitory Rent and Management Committee as well. The total number of such teachers cannot exceed 10% of residents in dormitory. 三、凡符合本細則第二點之條件者，應填具申請表，檢附戶籍、應聘資料及入境證明 (或依本細則第八點簽准之核定簽 )，經由系（所）主管及院

14、長分別簽註意見後，送交總務處資產管理組登記候配，由總務處視宿舍空出之實際情形，依規定審查分配後，簽請校長核定，並提委員會報告。 3. For applicant who meets the requirement of Clause 2, he/she should fill this application form, take letter of appointment and immigration proof (or clause 8 in this regulation), and submit to Supervisor of Department (or Graduate Sch

15、ool) for approval, then submit to the Office of General Affairs and register. Officer of General Affairs will check the status of rooms and arrange rooms according to regulations, and submit to the President for approval and report to Dormitory Rent and Management Committee. 四、宿舍借用人申請案經核准，於接獲通知後，應向總

16、務處資產管理組辦理簽訂宿舍借用契約等手續，並至財務處出納組繳交水電、瓦斯、設備、清潔維護等費用保證金新台幣壹萬伍仟元整後，領取鑰匙，除特殊原因外，應於十五日內遷入，逾期以棄權論。 宿舍借用人進住後，應逕洽該宿舍區自治管理委員會辦理自治管理費繳交事宜。 4. After getting letter of approval, applicant should go to Property and Management Office to register, and go to Accounting Department to pay NTD 15,000 as guarantee fee for

17、 utilities , gas, equipment, cleaning and maintenance. Then applicant will get the keys and need to move in within 15 day of letter of approval unless applicant has special reason. If applicant fails to move in within 15 days, he/she will forfeit his/her right to the approved space. Special waiver i

18、s required if cannot move in 15 days. After moving in, applicant needs to contact dormitory management team to pay maintenance cost monthly. 五、宿舍借用人離職、借住期滿者，應於兩個月內，結清宿舍水、電及瓦斯等費用後，向總務處資產管理組辦理歸還宿舍手續，保證金於手續辦妥後，無息退還，惟如有尚未繳納水電、瓦斯、設備清潔維護等費用時，則由總務處就該保證金內如數扣繳後，餘數退還。 5. When applicant leaves his/her appointm

19、ent or reaches the end of living period, applicant will pay all water, electricity and gas bills within 2 months. And go to Property Management Division to do all sign-out procedures. After all procedures are clearly done, NTD 15,000 deposit will be returned without interest. If there are dues which

20、 are not paid off, General Offices will deduct such costs from the deposit and return the rest. 第 2 頁 /共 3 頁 六、逾期而未遷離者，按月扣繳違約金，每月新台幣貳萬元整， 但因特殊需要經校長核准延長借用者，每月則酌收延期使用費壹萬元整 ，並按月由出納組從借用人之月薪內扣除。 6. If the applicant does not move out after reaching end of living period, General Office will collect NTD 20,

21、000 monthly as rent and penalty. But if there are any special reasons and the applicant gets approval from the President, to live longer time, General Office will collect NTD 10,000 per month and deduct such amount from applicants salary. 七 、本宿舍至少須保留總戶數五分之一，供旅 外學人申請。 凡未符合本細則第二點條件之本校新聘編制內專任教師，因特殊情況，且

22、學術研究優異，經相關系所、學院主管推薦，教務長會簽意見，奉校長核准者，得比照旅外學人，依本細則規定，申請配借前項尚有空餘之宿舍。 7. At least 1/5th of all available rooms will be reserved for oversea applicants. For all new full time teachers who do not meet requirements of Clause 2 of this regulation may apply for any available rooms. Such applicants may have sp

23、ecial reasons, have outstanding performance, and get recommendations from department, graduated school, and recommendations from Officer of Academic Affairs and the President. 八 、本細則經校務會議討論通過後實施，修正時亦同。 8. This regulation is passed after discussion in Academic Affairs meeting, dated April 9, 2014. An

24、y amendment will require approval from Academic Affairs. 第 2 頁 /共 3 頁 國立成功大學宿舍配借積點表 職務 （最高） 年資 （最高） 眷口 (最高 ) 兼職 （最高） 教 師 教授 40 副教授 32 助理教授 30 講師 24 助教 16 1.在本校服務一年以一 1 點計，不足一年者以一年。 2.在其他公立機關學校服務一年，以半點計，不足一年者以一年計。 3.職工最近三年考積 每考一次甲等，加計 1 點，最高為 3點。 共 點 配偶女子 人 父母 人 每口 1點，最多算至 5點。 共 點 1.凡曾專 (兼 )任或現任本校院、處

25、、室等一級單位主管，或系、所、科等主管，每兼一 年加 2 點。 2.凡曾專 (兼 )任或現任本校二級單位主管，或校、院、處秘書等，每兼一年加 1點。 3.上述主管限編制內主管，兼職不足一年者，以一年計。 共 點 職 員 簡任、相當簡任 35 薦任、相當薦任 30 委任、相當委任 (含駐警） 18 技工 工友 技工、駕駛 15 工友 12 一、 身心障礙 :(申請時請檢附身心障礙手冊影本 ) 1.極重度身心障礙加 40點。 2.重度身心障礙加 30 點。 3.中度身心障礙加 20 點。 4.輕度身心障礙加 10 點。 二、自有住宅與戶籍距離 : 本人、配偶或未成年子女之自有住宅，或戶籍在距離本校 20 公里以上得申請宿舍，其距離 : 1.20公里至 50公里加 1 點。 2.51公里至 100 公里加 2 點。 3.101 公里以上加 5 點。 三、以上計點如積點相同者，以職務積點高者優先，又若職務積點仍相同，則以戶籍地較遠者為優先，若各項積點仍復相同時，則以抽籤決定之。 四、申請者配偶出國進修，眷口仍可計點。單房間職務宿舍眷口不計點數。 五、技工、工友部份，得單獨計點、不與教職員合併計評比。 總點數 申請人簽章