Name% C, E2 u. b4 s
| % Q2 s- x$ ^) s# C S3 S
9 D# G$ K% @; ~* e
| Gender) l1 e3 t# Z) F/ t( |% S& h
| □Male □Female) Z7 l1 Y! v6 B" R; W% b/ H0 V
|
Passport No.! Y O" d/ ?5 b
| : y3 X+ j4 N* {3 U$ i
2 y) ]( V' D# x8 V7 J! @
| Date of Birth2 L6 k! O2 n3 U: x+ M1 l
| Year Month Day- |* d/ H+ n, @3 P& \' C, _2 |5 s- y
|
Telephone
: }/ N5 p( V6 E- V | (Mobile)( l4 _. i/ U! M+ g7 D! l
| (Home)
, E6 @6 r; h* b8 z$ J | E-mail：
. m3 S3 Y9 C% I& Y8 f9 c |
Fax
9 ]/ w+ i$ T! A" d' |( t |
7 s. j z+ w+ ?- S5 O | Nationality
1 [. u. [) n9 J- _ | |
Name of School; ]) Z" f& @! f% p
| 4 J# s2 W( C* U7 s! Y, l
| Major # R6 ^2 b$ p/ L2 P" D4 p
| |
Address! L; |5 q, O( _4 l. v6 I
|
, _5 @+ |$ I1 ~- u/ j |
Eating habits
" q3 _& y5 `/ n8 x' A4 | | □Non-vegetarian ( a3 w' @" F$ W7 k/ u, ^
□Vegetarian) |- j$ {: C5 t' d; H
| Others： Requirements：: N$ |0 K! r3 K; N& m/ }) [- y
|
Attending Stage
; S$ H0 P) J" G | □ First Stage 7/16（Mon.）~7/17（Tue.）(New Taipei City Hakka Museum )
% R1 w+ }( z8 Y' O- z□ Second Stage 7/18（Wed）~7/19（Thu.）(New Taipei City Hakka Museum)
; {' Q7 @% \, ?$ G |
Parents Information
( {2 U7 C2 }" j! N T7 | | Name of the parents U! c/ `% E. Q0 n
| □Agree5 y4 I; |" T! \# h* p
□Disagree' o, g/ {) o! k2 |- U6 `
) h. n9 x1 V0 n/ ]4 T
| Date of Birth
' B% H! l. I, F* v8 E3 r | Year Month Day
6 U5 v* ^6 |: R3 |8 d |
ID No.
9 O7 q& ?% r6 C ?+ c* z% l9 I6 u | |
Parents Agreement; b; Q' r& B3 d3 W
| Signature Date. P0 i6 h" |* U
|
Emergency Contact person% V" a0 h9 o0 T6 I* V
| (Mobile)
6 H) s. O; A7 z7 c0 K | (Home)
% d* s6 N8 S& U/ b7 [% i | (Work)5 H) F- R* Q+ Y% l2 y9 w& t
| Relationship to Applicant
$ v# D" B3 Y2 l |
Comments | Note:
; R, J0 q. V' {/ i8 FPersonal 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. : L% o4 U! f3 t* |6 l8 h
|
發表於 2012-5-21 09:03:55
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