請家長或監護人填寫 To be filled out by a parent/guardian  
我們感到十分榮幸，您願意讓您的孩子來參加我們為期一星期的營會。請花點時間回答本表格內的問題，因為知道您對孩子的心意，對我們來說很重要，這樣能幫助我們在營會中，更好地服務您的孩子。
We are honored that you are entrusting your children to us for this week-long conference. Please take the time to answer the question on this form, as your thoughts on your child are important to us, and will help us better serve them during this conference.
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學生姓名 Student's Name   *
保險資料 Insurance Information
為了幫小於18歲的孩童保險，請提供家長個人資料。 To apply for insurance for children under 18, please provide your personal information.
家長姓名 Your Name   *
與學生的關係 Relationship with Student *
家長身分證字號 Your National Identification Card  *
非台灣人，請填寫國籍及護照號碼。For non-Taiwanese, please fill in your nationality and passport number. 
家長生日 Your Birthday *
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金額 Payment *
請注意，基督學院宿舍只有床板，沒有床墊。如果需要我們幫您租借睡袋，請在以下勾選。
Please note, the beds in the dormitories at Christ College do not have mattresses. Check below if you wish us to rent a sleeping bag on your behalf.  
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付款方式 Payment Method
郵政劃撥 Postal Remittance
帳號 Account No.: 19289462
戶名 Account Name: 培基文教基金會‬
(請在劃撥單上註明申請人姓名) (please specify the applicant’s name on the form)

銀行匯款 Bank Remittance
銀行 Bank Name: 台灣中小企業銀行  南台北分行  
代號 Routing Number: 050
帳號 Account Number: 06112006131
戶名 Account Name: 財團法人培基文教基金會
(請在匯款單上註明申請人姓名 ‬(please specify applicant’s name on the form)
付款資訊 Payment Information *
Payment Date 付款日期
Please fill in your estimated payment time. 請填寫預計付款時間。
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E-mail *
行動電話 Phone (Mobile)   *
公司電話 Phone (Work)  
家裡電話 Phone (Home)   *
1. 對孩子的期望 Your hopes for your child *
您對孩子的未來有哪些期望? 例如：學業、未來方向、與神的關係⋯ 等。What are some of your future hopes for your child? (For example, in regards to their academics, future direction, relationship with God)
2. 為孩子的掛慮 Your worries for your child *
您預期孩子會面臨哪些挑戰? 例如：學業、個人品格特質、他們的人際關係、他們的靈命成長⋯ 等。What are some of the challenges that you anticipate your child facing? (For example: in academics, in regards to their personal character, in their interactions with others, their spiritual growth, etc?)
3. 孩子目前的需要 Your child's current needs *
為了更好照顧您的孩子，請告知他/她最近在接受哪些方面的醫療或是輔導，以確保您的孩子在營會中能得到合宜的照顧。若沒有任何需要，請在下面註明。In order to best care for your child, please let us know any medical treatment or counseling that your child has been recently receiving to ensure your child is properly cared for during the conference. If there are none, please state so below.
4. 備註 Other Comments
品格委身 Character Commitment *
我已閱讀並同意營會對於品格的委身 (http://thevoiceconference.org/zh-hant/attend/voice/apply/commitment/)，並會盡力支持 VOICE 提供每位學生最好的學習環境。I have read and agree with all of the Character Commitments (http://thevoiceconference.org/attend/voice/apply/commitment/) and support VOICE in its effort to provide the best possible learning environment for every student.  
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