I-SHOU UNIVERSITY
Application Form for Establishment of Student Study Groups in the Second
Semester of Academic Year 2012
Application No.:
Application
Date
/
/
(y/m/d)
No. of
Participants
Persons
□ University Courses (Course Title:
Collegiate Exam Subject:
□ Yes
(Filled in by CTLD)
);
□ No
□ Professional Skills Tests (□ Language Proficiency □ Computer Skills
Topic
□ Professional Skills)
□ National Examinations (□ Certificate
Supervisor
Group Duration
Group
Convener
□ Civil Examination)
□ Reading of Classics (Book Title:
)
Mr./Ms.
at College of
of Department of
From
/
/
/
/
(y/m/d) To
(y/m/d)
(Group sessions in this semester should fall between March 20, 2013 ~ June 21, 2013)
Mr./Ms.
in Class
of Department of
at
College of
Mobile
ISU e-mail
Supporting
Documents
(1) Professional Skills Tests: Proofs of taking the test (e.g. photocopies of admission
tickets, receipts of registration fees, etc.)
(2) National Examinations:
a. Proofs of taking the exam (e.g. photocopies of admission tickets, receipts of
registration fees, etc.)
b. An exam preparation plan and teaching materials provided by the supervisor
(please give a summary in the column Description.)
* The proofs mentioned above should be submitted with this application form. If any
participant has not registered for the test/exam yet, he or she may submit the proof
later.
Location
* Group members should meet at a classroom, seminar room or conference room on
campus. Please abide by the regulations and rules set forth by the Curriculum Section to
apply for classroom reservation.
* Group members may meet at PBL Rooms 6030304 or 6030404 at the International
College Building on Main Campus. Please visit Office of Library and Information
Services  Services  Study carrels and PBL discussion rooms to book one PBL room.
* After the list of approved student study groups is announced, CTLD will again confirm
the location where each group meets, and make random inspections of all groups during
this semester.
Group Sessions
Example:
Expected Date & Time
Location
March 25, 2013
An
expected
10:00~12:00
location; after
(The first group session the
list
of
1
Description
1. Reviewing the first chapter on Calculus, doing
previous exercises, and discussing these
questions.
I-SHOU UNIVERSITY
Application Form for Establishment of Student Study Groups in the Second
Semester of Academic Year 2012
Application No.:
(Filled in by CTLD)
should be scheduled on approved
and after March 20, 2013.) student study
groups
is
announced,
CTLD
will
again confirm
the
location
where
each
group meets.
1st
2nd
3rd
4th
5th
6th
* Please specify:
Expected
Achievements
Example 1: We form a student study group on university courses, and there are ten group members. It is
expected that nine of us will receive a higher score at the final exam, thereby accounting for an
improvement rate of 90%.
Example 2: We form a student study group on the TQC test, and there are ten group members. All the
members have registered for this test, five of whom are expected to pass this test.
Example 3: We form a student study group on reading of classics, and there are ten group members. Each
member will submit a report at the end of this semester.
* Please specify:
* Subsidies:
1. Only photocopying expenses and a work-study pay to the group convener will be covered.
2. The photocopying subsidy is NT$1,000.
3. The group convener will receive a work-study pay of 15 hours.
Item
Photocopying
Expenses
Unit Price
(NT$)
1,000
Quantity
1 Batch
2
Total
(NT$)
Notes
1,000
(1) The
maximum
subsidy
on
photocopying is NT$1,000. The
group convener should only have
materials relevant to the group copied
at the photocopy shop on campus
on credit (signed by the convener).
(2) Any invoices or receipts issued by
photocopy shops other than the one
I-SHOU UNIVERSITY
Application Form for Establishment of Student Study Groups in the Second
Semester of Academic Year 2012
Application No.:
(Filled in by CTLD)
on campus will NOT be accepted.
(3) The group convener should keep the
first page of materials copied each
time, clearly state the number of
copies, and submit these pages to
CTLD after June 21, 2013.
(4) All the expenses incurred for
preparation of a student study group
before a list of approved student
study groups is announced will not be
covered by CTLD.
Work-Study Pay
109
15 Hours
1,635
(1) The hourly wage is NT$109, and the
group convener will receive a
work-study pay of 15 hours.
(2) Only the group convener is entitled to
the work-study pay. The group
convener must not have other
work-study jobs during the time the
group meets.
(3) The group convener should complete
and submit a receipt of work-study
pay and a work-study record sheet to
CTLD after June 21, 2013.
(4) All the expenses incurred for
preparation of a student study group
before a list of approved student
study groups is announced will not be
covered by CTLD.
* Applications will be reviewed by a committee, and the number of student study groups receiving a subsidy is
determined based on the annual budget.
* If more space is needed, attach additional page(s).
Supervisor’s Signature:
3
List of Student Study Group Members in the Second Semester of
Academic Year 2012
No.
Department
Class
Student No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
* If more space is needed, attach additional page(s).
4
Name