劃岀「妳」想同行計劃 “BE YOUR LIFE DESIGNER” Women Empowerment PROGRAMME 報名表 
Please complete this form in BLOCK LETTERS and must complete the items with* 請以大楷英文填寫以下問卷, 所有*項必須填寫
English Name 英文姓名
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Chinese Name 中文姓名
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Nick Name 別名
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Year of Birth 出生年份
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Gender 性別
Nationality 國籍
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Contact Number 聯絡電話
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Email Address 電郵地址
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Educational Status 教育狀況
Education Level 教育程度
Name of college/School  就讀院校/中學名稱
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Name of Programme 就讀學科
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Other Status 其他 (can tick one or more boxes as appropriate 可選多於一項)
Themes and Dates of Training Programme 日期
畢業後我打算.....
Career Interest (List out 3)我希望從事的工作:(可列出最多三樣)
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Channel(s) to Reach this Program獲悉本計劃之途徑
Declaration on Collection and Use of Personal Data 有關收集及使用個人資料之聲明 (Please tick the following box after read 請閱讀後剔選以下方格) *
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