Name
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7 @. e: y9 ^+ ]+ G' ~: r | Gender
0 P& ?3 n6 n9 ~( K: G7 h$ ] | □Male □Female
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Passport No.+ C5 a# d5 a+ x x3 O
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| Date of Birth* U. p& |2 Y U2 Q
| Year Month Day' W+ P9 U% k$ ?. e
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Telephone , o5 V9 k+ I3 p( C8 W1 q
| (Mobile)1 j; Z4 h; v9 C3 I7 r+ c" @
| (Home)
% J/ r5 x9 H+ u3 ^4 q6 m# G | E-mail:
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Fax
Q9 O% A' D7 A$ q! H4 @' F |
4 v1 j" [+ d; F8 ^5 q/ A$ C6 U0 @ | Nationality
2 X2 V. t! ]( Q9 m! F' _ | |
Name of School- ^) `5 k2 P) h* S9 z+ k& e& c
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8 }/ y9 O* @8 J. A: Z# b | Major 8 x3 V: o# o' w+ ^6 J R& T
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Address
0 d/ d% p3 C7 C8 {/ \# s | 3 a" u, v2 X. j/ B$ I9 P
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Eating habits
B/ |: L7 ]3 U' Q | □Non-vegetarian
' C4 J. i9 K; K# c) i+ a2 `□Vegetarian
+ I9 P1 B1 P& e4 [) j | Others: Requirements:
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Attending Stage
6 z, }& g) I9 _* P2 Q; _4 b | □ First Stage 7/16(Mon.)~7/17(Tue.)(New Taipei City Hakka Museum )
9 v8 P8 u/ T4 u□ Second Stage 7/18(Wed)~7/19(Thu.)(New Taipei City Hakka Museum)
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Parents Information# {* O; e5 t1 I: o& n
| Name of the parents
, O% W" J% K4 g' b/ Q | □Agree
5 u: p+ t: K, Z$ z□Disagree
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9 U3 t" b% s" C | Date of Birth c5 M7 i5 D6 X0 j4 k
| Year Month Day* b1 c2 [$ a8 o) C
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ID No.
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Parents Agreement" n# ^5 U6 t6 [
| Signature Date- G0 h4 K, z: a' G G+ \) ?( Q
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Emergency Contact person
/ J% Q. p7 H: F( J% _ | (Mobile)0 h+ s) k4 _0 d
| (Home)
6 y1 m! J! O& b! M$ ~ | (Work)9 f6 K4 y: \" P
| Relationship to Applicant6 Z' R0 O% A0 h, d
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Comments | Note: 5 \$ A Q; T8 U0 r6 J/ C
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. 4 q0 a @3 Y" h1 B; s7 P+ R
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