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報名表格 Application Form
藝無疆2018報名詳情 Cross All Borders 2018 Application Details:
http://www.adahk.org.hk/?a=doc&id=2996&tab=2
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藝無疆︰新晉展能藝術家大匯展2018 Cross All Borders: Hong Kong Festival Showcasing New Visual Artists with Disabilities 2018
香港展能藝術會 Arts with the Disabled Association Hong Kong
第一部份 －參加者資料 Part I－ Applicant Information
中文姓名 Chinese Name
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Your answer
英文姓名 English Name
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Your answer
性別 Gender
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男 Male
女 Female
年齡 Age
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Your answer
出生日期 (日/月/年) Date of Birth (D/M/Y)
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MM
/
DD
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YYYY
組別 Division
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兒童組 （12歲或以下*）*以2018年4月30日為計算日期 Children Division (Age12 or below*) *Age calculated from April 30, 2018
青少年組 （13至21歲*）*以2018年4月30日為計算日期 Youth Division (Age13-21*) *Age calculated from April 30, 2018
公開組 （22歲或以上*）*以2018年4月30日為計算日期 Open Division (Age22 or above*) *Age calculated from April 30, 2018
電話 Tel
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Your answer
傳真 Fax
Your answer
電郵 Email
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Your answer
通訊地址 Address
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Your answer
身體狀況 Physical Condition
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視障 Visual Impairment
聽障 Hearing Impairment
言語障礙 Speech Impairment
自閉特色 Autistic
輕度智障 Intellectual Disability (Mild)
中度智障 Intellectual Disability (Moderate)
嚴重智障 Intellectual Disability (Severe)
精神障礙 Psychosocial Disability
肢體障礙 Ambulant Disability
輪椅使用者 Wheelchair User
特殊學習需要 Specific Learning Needs
過度活躍 / 專注力不足 Hyperactivity / Attention Deficit
長期病患 Chronic Diseases
Other:
Required
聯絡人／家長／監護人／負責老師／職員資料(如適用) Contact Person／Parent／Guardian／Teacher／Staff Information ( if applicable)
中文姓名 Chinese Name
Your answer
英文姓名 English Name
Your answer
機構名稱 (如適用)（中文）Organization ( if applicable) (Chi)
Your answer
機構名稱 (如適用)（英文）Organization ( if applicable)（Eng）
Your answer
與參加者關係 Relationship with Participant
Your answer
電話 Tel
Your answer
傳真 Fax
Your answer
電郵 Email
Your answer
通訊地址 Address
Your answer
第二部份－作品資料 Part II－Artwork Information
個人簡介 (50字以內) Personal Statement (In 50 words or less)
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Your answer
參賽作品一Artwork 1
作品名稱 Name of Artwork
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Your answer
創作理念 (50字以內) Artist’s Statement (In 50 words or less)
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Your answer
規格尺寸 [長 x 闊 x 高 厘米 cm ] Size [L x W x H cm ]
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Your answer
創作年份 Creation Year
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Choose
2018
2017
2016
2015
2014
創作物料 (請註明作品所用的物料) Type of Materials(Please specify the materials used)
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Your answer
作品類別 Type of Artwork
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中國繪畫 Chinese Painting
西方繪畫 Western Painting
電腦繪圖設計 Graphic design
攝影 Photography
版畫 Printmaking
陶瓷 Ceramics
雕塑 Sculpture
紡織品 Weaving
混合媒體 Multi-media artworks
Other:
Required
電腦圖片檔案 (參賽作品一) Photo File Name (Artwork 1)
以 Dropbox 或 Google Drive 等線上軟體發送，請在以下（其他：）空格中填寫相關鏈接 Send by Dropbox or Google Drive, please provide link in the below column
*
Your answer
參賽作品二 Artwork 2
作品名稱 Name of Artwork
Your answer
創作理念 (50字以內) Artist’s Statement ( In 50 words or less)
Your answer
規格尺寸 [長 x 闊 x 高 厘米 cm ] Size [L x W x H cm ]
Your answer
創作年份 Creation Year
Choose
2018
2017
2016
2015
2014
創作物料 (請註明作品所用的物料) Type of Materials(Please specify the materials used)
Your answer
作品類別 Type of Artwork
*
中國繪畫 Chinese Painting
西方繪畫 Western Painting
電腦繪圖設計 Graphic design
攝影 Photography
版畫 Printmaking
陶瓷 Ceramics
雕塑 Sculpture
紡織品 Weaving
混合媒體 Multi-media artworks
Other:
Required
電腦圖片檔案 (參賽作品二) Photo File Name (Artwork 2)
以 Dropbox 或 Google Drive 等線上軟體發送，請在以下（其他：）空格中填寫相關鏈接 Send by Dropbox or Google Drive, please provide link in the below collumn
*
Your answer
Declaration
本人現聲明參賽作品為參加者的個人原創作品，表格上填報的所有資料屬實及正確，並明白如有關資料與事實不符，將會被取消參展資格。I declare that the artworks are the applicant’s original work, the above information is true and I understand that the enrolment will be cancelled if false information is given.
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同意 Agree
本人已細閱並接受報名表內的所有條款及細則，並盡量出席展覽之開幕及頒獎禮。I understand and abide the rules announced by the ADA. And I agree to attend the Opening and Prize Presentation Ceremony of the Festival.
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同意 Agree
聯絡人／家長／監護人／負責老師／職員 姓名 (凡未滿18歲之參加者須由家長／監護人／負責老師／職員填寫 For applicants under 18 years old, endorsement by parent or guardian, teacher or Staff is required.）
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Your answer
申請日期(日/月/年) Application Date(D/M/Y)
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MM
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DD
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YYYY
請覆核資料正確，按下「提交」後將不能返回報名表格 Please double check all information is correct , you will not be able to return to application form after submission.
查詢 Enquiry
香港展能藝術會 Arts with the Disabled Association Hong Kong
電話Tel：2855 9548 傳真Fax：2872 5246
電郵Email：
cab2018artwork@adahk.org.hk
網頁Website：
www.adahk.org.hk
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