儀器線上預約 - 申請帳號

請輸入以下欄位中的資訊. *為必要欄位 (Please enter the information below. Fields marked * are required.)
有 * 請務必確認無誤. (Please confirm again if there is a symbol * .)
*帳號(Account)  4~20碼文數字(4~20 alphanumeric characters)
*密碼(Password)  4~20碼文數字或特殊符號(4~20 alphanumeric or special characters)
*密碼確認(Confirm Password)  與密碼相同(Password)
*門禁磁卡密碼(Password to Access Card)  請自行設定四碼數字(four-digit number)
*使用者身份(User Identity)
*申請人姓名(Username)
*性別(Gender)
學號(校外免填)(Student ID(off-campus exemption))
*電話(Phone)
*E-mail
通訊地址(Address)
*隸屬單位(學校/系所)(Institution Name(School/Department)) 公司名稱/學校(Company Name/School Name)
校內分機(Extension Number) 

部門/系所(Department)
最高學歷/目前就讀(Education)
目前就讀年級(Grade)
預定畢業年月(Graduation Date-yyyyMM)(例如:200806)
操作方式(Operating Mode)
校外人士只開放委託操作(Only request operations are open to outsiders.)
*指導教授(Professor)  無指導教授請填自己的姓名和E-mail(Please fill in your name and e-mail if you don't have a professor/adviser)
*教授e-mail(E-mail to Professor)
*醫學院核心設施實驗室使用及管理要點(General safety and health regulations of nano center) 請先閱讀 閱讀後同意請於前方方格打勾(Please read the regulations and check the checkbox.

請輸入下圖字樣(Type the words below):


點擊圖片可以更換驗證碼(Click to Refresh)



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