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JA Job Shadowing Application Form 2018/19
Please complete this form and submit to JA on or before 15 September (Friday).
請填妥以下表格,並於9月15日(五) 或之前交回JA。
School Information 學校資料
English Name 英文名稱 *
Your answer
Chinese Name 中文名稱 *
Your answer
English Address 英文地址 *
Street No. & Street
Your answer
*
District
Your answer
*
HK/KLN/NT
Chinese Address 中文地址 *
Your answer
School Tel 學校電話 *
Your answer
School Fax 傳真號碼 *
Your answer
School Website 學校網址
Your answer
Head of School 校長
English Name 英文姓名 *
Sal 稱呼
*
Surname 姓
Your answer
*
First Name 名
Your answer
Chinese Name 中文姓名 *
Your answer
Email Address 電郵地址
Your answer
Office Tel. No. 辦公室電話
Your answer
Link Teacher 負責老師
English Name 英文姓名 *
Sal 稱呼
*
Surname 姓
Your answer
*
First Name 名
Your answer
Chinese Name 中文姓名
Your answer
Position 職位 *
Your answer
Office Tel No. 辦公室電話 *
Your answer
Mobile No. 手提電話 *
Your answer
Email Address 電郵地址 *
Your answer
Expected Number of Participating Student 預印參與學生人數
Please limit your application of 10-20 students per form. 申請學生人數以10-20位為每級限額
Form 4 中四
Number of Student 學生人數
Your answer
Form 5 中五
Number of Student 學生人數
Your answer
Form 6 中六
Number of Student 學生人數
Your answer
Participation Schedule 參與日期 (Job Shadowing Day 工作影子日)
Please choose your preferred month for Job Shadowing Day. 請選擇 貴校擬舉辦工作影子日的月份
**Actual number of participating students and date of "Job Shadow Day" will be subjected to the final decision of the host company. 實際可參與工作影子計劃的學生人數及「工作影子日」之確實日期將視乎機構的最終決定。
Declaration 聲明
I declare that the information given in this application is true and accurate, and confirm that this application has been endorsed and supported by the school. I hereby authorise Junior Achievement Hong Kong (JA) to contact relevant parties and verify information given in this application form.

本人聲明此申請表格內之資料屬實及準確,並確定此申請已得到校方認可及支持。本人謹此授權青年成就香港部與有關人士聯絡,核實申請表格內之資料。

*
Name 姓名 *
Your answer
Position 職位 *
Your answer
Date 日期 *
MM
/
DD
/
YYYY
Please print a copy of this completed form for your record before submitting this form. 遞交前,請先列印已填妥的申請表以作記錄。
How do you know about this program? 從哪渠道得知此課程?
Your answer
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