Name
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* ^( r0 C" n7 v8 P2 \' o
- e9 c! W k b6 q3 A | Gender
$ N [: A2 o" P3 R/ E | □Male □Female
: ?6 g& B5 G$ f& j) I |
Passport No.
0 T4 ^9 q: u* o2 c% o |
" |% `+ h7 D; p6 b' D4 T ( x' Z* J5 o6 G; p
| Date of Birth
3 U2 r& P, r( w" @, d2 i | Year Month Day! d: N% `# E( p- `3 q: C. c
|
Telephone . J' E' ]1 s& U, Y: _8 C+ ~" @. f
| (Mobile)
7 t" v, x6 l' Y: K, D6 @( M# r | (Home)* P6 M$ r/ N, t ]$ i8 F' ]
| E-mail:- v0 r5 _, O5 A
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Fax - m4 V$ T1 W3 B# q6 A. a
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) @7 ^8 q+ p5 |, r+ R( [6 w1 D" F | Nationality
: V% Q1 w% [5 G9 ?4 G0 ]' q | |
Name of School6 @) |* j" J/ R* K
| 6 C, J% z. l2 {$ ]
| Major
) V1 e* F% B4 I6 {7 p | |
Address4 v7 D4 C+ e" k. G2 U4 t& y& {0 O) M# {
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5 ^7 Z" d$ W- G; b2 q7 ?$ G |
Eating habits
' Q9 p0 `) P2 v) V a% P& [* g | □Non-vegetarian 7 X$ c8 }$ z0 D( j4 j1 _
□Vegetarian
' b7 j* @- x% \: a1 T | Others: Requirements:: ^8 p1 I2 f+ N" @ W4 C4 x
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Attending Stage- s) A. A# p, z7 A$ C
| □ First Stage 7/16(Mon.)~7/17(Tue.)(New Taipei City Hakka Museum )1 B: p' B$ v T& W [3 C/ t
□ Second Stage 7/18(Wed)~7/19(Thu.)(New Taipei City Hakka Museum)* Q% }% ^# @7 o+ z. L8 v2 A# O
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Parents Information
6 S% d; I' s [ | Name of the parents
; l2 X5 a( W# F+ w, J& W" ]. K# y5 N0 C | □Agree @: E3 S' l$ L' G
□Disagree
. l$ T: [/ C& U. U2 X
( d! g) v2 [+ g1 }: N | Date of Birth
2 a& Z/ q; F' g" |+ p2 k% k0 q | Year Month Day
. _+ |* R" |1 Q) M) [+ z- F. _ |
ID No.5 M& k8 k9 y4 l
| |
Parents Agreement) ~9 C9 s. y3 f" ?: S$ \( x
| Signature Date. r ^2 h. B0 [! {0 u% o7 I: b, q
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Emergency Contact person
. a+ J" y; T0 }+ \) i7 A | (Mobile) m% d4 p" Y1 y
| (Home)
2 s7 r1 O$ p( b4 ? | (Work)
- ^: z, N1 j6 m( O% T2 E6 ~ N3 n | Relationship to Applicant2 D4 @( _' V- @( b3 ~# U$ I
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Comments | Note:
i7 G5 V: K! [: nPersonal 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. 6 p, y. |) i; r& ?0 L$ H
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