Declaration of Non-Household Registration for

Feng Chia University International Applicants

I, (print name), declare that I have never been

registered to a household in Taiwan (ROC). If this statement is untrue, I accept that my
admission, enrollment, or graduation status shall be disqualified without any dispute and
that no graduation certificate shall be issued from the school.

* The following information is required for students whose parent(s) hold ROC
citizenship.

Father’s Chinese Name: Date of Birth:

Father’s ROC ID number:

Mother’s Chinese Name: Date of Birth:

Mother’s ROC ID number:

Applicant’s Signature:

Passport (ARC) No.:

Phone:

Email:

Date: (Y) (M) (D)