I -SHOU UNI VERSI T Y Fa culty Plea and Arbitra tio n Co mmittee Appea l Fo rm Appellant’s National ID No. / Name Passport No. School Name & Date of Birth Job Title Residential Address & Contact Phone No. Agent’s / Representative’s (if applicable) Name National ID No. / Date of Birth Passport No. Residential Address & Contact Phone No. The school or the competent authority whose action is being appealed: I. The facts and reasons for this appeal: II. Any remedial measures you expect: III. Supporting Documents and Evidence (please make a list below and attach them to this form) IV. Have you filed any administrative appeal or lawsuit in relation to this case to the government or the court (Note): Note: Pursuant to Article 14 of the Regulations for Arbitration of Faculty Pleas and Organization of Faculty Plea and Arbitration Committee at I-Shou University: Should a faculty member making a plea simultaneously or sequentially make an administrative appeal, administrative lawsuit, civil lawsuit or criminal lawsuit, or apply for mediation, arbitration and ruling pursuant to the Act for Settlement of Labor-Management Disputes regarding the plea case, the Committee shall be notified in writing. When the Committee is informed of any of the aforesaid situations, the arbitration of the case in question shall be suspended, and the appellant shall be notified in writing. Once the cause for suspending the arbitration no longer exists, the arbitration shall be resumed as requested by the appellant in writing. Should the decision of all or part of the plea case depends on whether a legal relation of this case stands with an administrative appeal, lawsuit or settlements of labor-management disputes, the Committee shall suspend the arbitration and notify the appellant in writing before the administrative appeal, lawsuit or settlements of labor-management disputes end, and resume the arbitration once the cause for suspending the arbitration no longer exists. V. Date of Appeal: Appellant (Signature/Seal) Agent Representative Date: , (Signature/Seal) (m/d/y)