Name) y; C5 b$ l" d8 `; a, K* P; M7 E- ]
| # s3 X' Q- [3 J8 e( G
# q0 M+ B; g) c | Gender& n' n: [, h6 N& b! w
| □Male □Female
% K5 K6 R; m. h: t/ j! s+ @ |
Passport No.
1 O) H( ^7 O; u" T |
* ^6 h6 K3 p6 K1 M
* o, V0 t. Q6 q+ J- f | Date of Birth0 P( o) n; b( S5 D0 Y
| Year Month Day& f& `2 U, t$ L1 e
|
Telephone / x- r3 D" ~3 L8 E
| (Mobile)
' G! Y! x$ x( e0 d | (Home). D/ V# d; K* q
| E-mail：) k. K& h3 _" \# Y- l$ j% Y
|
Fax
: x5 I# t1 U0 g |
* d7 m; n7 Q8 n8 r/ T& g | Nationality; y: ^2 F$ J1 y
| |
Name of School) c/ p* m+ I# K. E* t0 V
|
. R- x% e/ I1 i | Major 1 u6 h4 A' ], z* D8 }
| |
Address0 `. a x- y$ t
| ' `- P; k, @3 a, I, T7 m& [) d
|
Eating habits; g- a: R0 _# }9 A* c
| □Non-vegetarian
; q% Q+ w$ v6 W, Z; s* E) d3 _□Vegetarian
2 T# O% L, f6 \* C, W( k8 Q* Q | Others： Requirements：
1 L! z7 g! m8 {. G' \; G |
Attending Stage
. C* L' O& j* T$ @$ ~. g | □ First Stage 7/16（Mon.）~7/17（Tue.）(New Taipei City Hakka Museum )) Q1 @* U/ X, B; s
□ Second Stage 7/18（Wed）~7/19（Thu.）(New Taipei City Hakka Museum)
/ j0 W6 J* N: [0 `/ O! F* X |
Parents Information5 x8 J$ w9 h0 N: h8 @+ n4 R
| Name of the parents
' t, o1 \# u* _8 o# |2 ` | □Agree/ X- X1 Y% N7 p7 j9 J
□Disagree
9 U3 M7 `8 w) H8 Z- u
$ A. a9 S4 e. j: B% I | Date of Birth
. H% m; r; n% T; K: q | Year Month Day' h5 z$ J. g5 h9 X) G# D& P4 X
|
ID No.' d. u3 R" U: T2 }
| |
Parents Agreement$ A: B. A; u9 u9 q6 P6 I# |
| Signature Date
% ]6 w$ P, s2 T" s4 e7 U4 X' f; K |
Emergency Contact person6 Q5 c1 M& ^$ Z: P
| (Mobile)
" f, \( l: N# r3 v0 K | (Home)
, J1 w/ `- z1 w" R$ z' { | (Work): K0 O- d. l" ]& `' t0 k, ~ { N
| Relationship to Applicant
) a, q- g2 ?! h* G, N |
Comments | Note: , {5 Q5 e9 c4 @
Personal Belongings: Sleeping bag or quilt , Toilet articles (Tooth cup, Toothbrush, Toothpaste, Towel), Clothing, Slippers, Coat, Umbrella, Healthy insurance card, Personal medications and a good mood.
! r9 i! l1 n1 D; F |
發表於 2012-5-21 09:03:55
收藏
讚