Name' {6 z( g0 x( x6 |) D# ?
| % _, p: L% C/ E$ V: k) y H: U3 G
! o5 V% s- B% _" T4 J1 r! E" b$ Y3 e | Gender
9 S; L0 ~8 ]: L* O | □Male □Female O$ W8 B) s2 K' x9 x
|
Passport No.% j9 Y' j7 T: C4 h. O+ g
| + O' c# B* [9 g4 K& n; }! @
* g7 h3 w# z* W1 {- w | Date of Birth
( O& @- f$ u2 k, u9 g | Year Month Day
; @, c! x( a7 {, R0 t! i( C2 m- U) } |
Telephone $ ]& M: n9 Z/ {% i& W" b, O" ~
| (Mobile)! a7 b0 s7 ~" W* B% o
| (Home)8 d9 M! c# E3 E; j' |4 d% p8 n" V
| E-mail：
6 P, f% W4 f# V5 K/ n% o |
Fax
, e) d0 |2 \# c0 G) ~ | # m' n* O+ B p5 U1 D
| Nationality
) S& a6 n: `% P, A; ?3 x4 o | |
Name of School- Y+ N& Z% \3 z% R) H% _* e
| 8 i) S' _ F" u
| Major ! v8 |1 ?9 U; b7 g5 u- i
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Address6 ~5 b( Z" s: {' w$ ?
|
+ t- X' g/ Q( E9 s) Q |
Eating habits
' C! N" V9 D9 P* ^' u/ N! f. H0 z | □Non-vegetarian / k8 z! T& V, t5 }- j& F
□Vegetarian' S0 `1 |' z1 q1 c0 c
| Others： Requirements：. j2 `8 D2 B, v2 A( ?" g! w3 j/ G- [
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Attending Stage
% Q9 _/ ]- R) `" S4 M* c* m | □ First Stage 7/16（Mon.）~7/17（Tue.）(New Taipei City Hakka Museum )
# J R4 @4 Z9 ~! n- S+ k□ Second Stage 7/18（Wed）~7/19（Thu.）(New Taipei City Hakka Museum) o' X% e; j* @: j# z
|
Parents Information2 t! q3 c/ z- G& l
| Name of the parents
# h7 [/ u2 C8 I | □Agree/ f; @" w+ }) c) G9 Y0 W3 a+ p9 a
□Disagree
9 | G& Y4 d6 k% h" ~1 p( c' t$ P3 Z O) m
: h9 u* E- ^2 A | Date of Birth
- u" j3 h' h& e# g( j | Year Month Day' [3 g3 T2 _% F$ Q8 l# r- W
|
ID No.
; W* p; D( K% q1 n4 k( V1 d5 N0 f | |
Parents Agreement
/ ]8 E" y1 E9 T# A( l3 T | Signature Date" k7 Z# Y3 C/ V, O u' p2 f
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Emergency Contact person' o+ L @* l7 C$ w3 ]/ p" [1 p4 h
| (Mobile)
5 U8 r. Q: _2 Y. Q | (Home)
$ e. F5 I# \ c5 e | (Work)* ~0 B2 W- Z7 G# i# w
| Relationship to Applicant
/ O( @: @- X% D x( v* A |
Comments | Note:
; ?3 V. ^% B/ Y+ HPersonal 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.
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發表於 2012-5-21 09:03:55
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