四川交通职业技术学院国际学生（语言进修生）退学申请表
WITHDRAWAL APPLICATION FOR INTERNATIONAL NON-DEGREE LANGUAGE STUDENTS OF SICHUAN VOCATIONAL AND TECHNICAL COLLEGE OF COMMUNICATIONS
姓名 NAME |
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性别 GENDER |
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国籍 NATIONALITY |
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联系电话 CONTACTNUMBER |
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紧急联系人及电话 EMERGENCY CONTACT & PHONE NUMBER |
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退学 申请事由REASONS FOR WITHDRAWAL |
1.是否已与家长/紧急联系人取得沟通交流（Have you communicated with parents / emergency contacts）：□是/Yes □否/No 2.退学具体申请事由（Specific reasons for withdrawal application）： 学生本人签名/STUDENT SIGNATURE：__________________ 申请日期/APPLICATION DATE：__________________ |
辅导员意见 COUNSELOR OPINION |
辅导员签字/COUNSELOR'S SIGNATURE：__________________ 日期/DATE：__________________ |
系部意见 DEPARTMENT OPINION |
负责人签字（盖章） /RESPONSIBLE PERSON'S SIGNATURE (STAMP)：__________________ 日期/DATE：__________________ |
国际学院意见 INTERNATIONAL COLLEGE OPINION |
负责人签字（盖章） /RESPONSIBLE PERSON'S SIGNATURE (STAMP)：__________________ 日期/DATE：__________________ |
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