Name
" U( ?& ]+ h2 `" ]6 E* p | / W3 a0 C7 Q5 n: A- \- O3 N( Q
" I+ z( F' }1 k5 Q | Gender
( a4 B# w& x' a; A ~ | □Male □Female
* s7 E, m6 Z9 X3 o9 i; O, ~ |
Passport No.
; r0 ?% Z& o* l* y! y0 o" F$ \% m | ' ~' v% ?9 K" `# s P/ s
1 h. Q4 S# _% d* d: |5 o1 I
| Date of Birth
( s2 c+ [# }- m0 P9 m | Year Month Day: d \: S) B! u% G6 f
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Telephone
% M+ @- t/ u) P- p4 @ | (Mobile)- ^. {" C, z: L4 w. B9 n& e
| (Home)1 W& w/ }" j# T1 s
| E-mail:+ H+ k( u1 `7 B: B2 I+ n5 [
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Fax : F: Y) Q, x" s. U! Y6 b2 Y% ]. [( Z
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; _" h" {8 r z3 W* c+ p$ V4 p4 q7 ~ | Nationality1 W4 ~$ E4 M5 g" ]0 i- d( P% v
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Name of School
+ n7 N/ o2 Y) J' _ | : `. F8 w% M* w; e
| Major 8 D) t2 W3 x( R0 @! M
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Address" K; V8 X7 g- v4 p& L5 S! N" t0 q% V7 I
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: _1 S/ C& T: ~# ~ |
Eating habits
4 Z9 x+ z* _# I- t8 I | □Non-vegetarian ; W* z- z i2 w3 `0 c, X4 R
□Vegetarian
+ Q; q" \9 ~# ` | Others: Requirements:2 H5 q0 _9 S. L
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Attending Stage
1 J9 i3 v* ]0 Y9 j | □ First Stage 7/16(Mon.)~7/17(Tue.)(New Taipei City Hakka Museum )
! J1 m4 H8 e! ~9 z4 \3 P9 V□ Second Stage 7/18(Wed)~7/19(Thu.)(New Taipei City Hakka Museum)
+ r1 b3 h, n, E0 f3 P! b: W9 r9 J |
Parents Information
' X: e/ l7 ]4 i+ g: p | Name of the parents- H V- i% H d! q5 U: i/ f
| □Agree
- f( n9 f7 @- w: M6 r6 R5 M□Disagree
7 }5 Z! r9 t: L9 q+ c2 ]; V 9 D3 {+ Q# c* N( V
| Date of Birth: X9 \; I5 ?& Y
| Year Month Day
* D% M& \' y1 }- m0 | |
ID No.
0 g$ Q0 C6 d4 {( @% @ | |
Parents Agreement
9 @% u: K- A+ ~' H | Signature Date
9 i1 a( L) m6 }5 y |
Emergency Contact person
4 h- f! V. S1 c, m E | (Mobile)
2 ~% E* g6 z$ z( i; e | (Home)/ m/ m1 i6 g% v3 r9 t4 ~: ?( c8 c
| (Work)$ e8 k! _; Y' p5 f
| Relationship to Applicant" r" z- d( f! l9 D
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Comments | Note: 1 p# Y; j0 ?* v' z, P
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. : ^# X0 b8 p3 O6 f4 O' c
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