<p> Please fax back to Ms Wincy Fong at 2748-8597 EMP- Training Programme for Ethnic Minority Groups 青出於「南」- 少數族裔培訓計劃 Application form 報名表 Photo of Applicant Part 1 (Personal Particulars)</p><p>Full name in English: Surname:</p><p>First / Other name:</p><p>Name in Chinese: HKID card / Passport No.: Nationality: Originated Country: Religion: Place of Birth: Date of Birth (dd/mm/yy): Duration of Residence in HK: Year Month Age: Sex: Marital Status: </p><p>Address for Correspondence (in English):</p><p>Joint Union / Agency: </p><p>Residential Telephone No.: Mobile Phone No.: E-mail Address: Level of Education: (please tick  the appropriate boxes)  Completed F.5  Completed F.4  Completed F.3  Completed F.2  Completed F.1  F.1 or below School Name: Working Experience ( including full time and part time): Post: Company: Last Date of Work: Referring Social Worker (if any) Name: Agency: Agency Telephone No.: Mobile Phone No.: Applicant with Disability (If You have a disability, please enter tick  and give details)  </p><p>1 Part 2 ( Course Choices) * Maximum Two courses can be chosen, please indicate your first and second priority by 1 and 2 Housekeeping Operations (房務事務課程) (Mid Oct., 07) Business & Office Operations (辦公室實務課程) (Mid Oct., 07) Elementary Programming Applications (初級電腦編程應用課程) (December, 07) Electronic & Computer Assembly (電子及電腦製作組裝) (April, 08) Fundamental Vehicle Servicing (汽車維修基礎課程) (July, 08) Western Food Production (西式餐飲) (July, 08)</p><p>Part 3 (Particulars of parent / guardian / spouse) Full Name in English: Surname:</p><p>First/ Other name:</p><p>Name in Chinese: Relationship to Applicant (in English): Contact Phone No.:</p><p>Part 4 (Declaration of Applicant)</p><p>I understand that provision of any false or misleading information therein shall lead to Disqualification of application without notice. Any fees paid are NOT refundable.</p><p>Applicant’s Signature: ______Date: ______</p><p>Part 5 (Declaration of parent / guardian) *For applicant under the age of 18 </p><p>I declare I am the parent / guardian of the applicant. I agree the applicant to apply for the above training course. </p><p>Parent/ Guardian’s Name: Parent/ Guardian’s Signature: ______Relationship to Applicant: Contact Phone No.: Date: </p><p>Address: Vocational Development Programme Office, VTC Youth College, Rm 044, G/F., Lily House, Larkspur Street, So Uk Estate, Cheung Sha Wan, Kowloon, Hong Kong. Tel: 2748 8586 Fax: 2748 8597 E-mail: [email protected] Web site: http://www.vtc.edu.hk/vdp/emp/index.htm </p><p>Revised on 27.8.07</p><p>2</p>