邢唷> svr欹 餜`ubjbjW賅8|55#44}}}}}8<4#99999 """""""$"&(L"Q}"}}99HL#}9}9"": ,!9"朆#Jj "b#0# R))!!)}1!""#)4 C: Please complete this form in English in BLOCK LETTERS (and in Chinese where specified). Home University Please ( appropriate.( Feng Chia University ( Shih Hsin University ( University of Macau( The Hong Kong Polytechnic University ( Tongji UniversityStudent ID No.:Department of Study:(in both Chinese and English)Programme of Study:(in both Chinese and English)Year of Study:PERSONAL PARTICULARSStudent Name:(in Chinese)(in English)Date of Birth:(DD/MMM/YYYY)Gender:Male / FemalePlace of Birth:ID numberTravel Document No. :(Home Return Permit no. from HK & Macau student / Travel Pass no. from Mainland student / Passport no. from Taiwan & Foreign Student )/n硂 Tf[轛aN翄鱏x0匭0W Tf[珟齆翄鱏x0餝~n Tf[bYM| Tf[gq鱏x Correspondence Address:(Chinese)Phone No: (Mobile)(Home) E-mail: Subject Choice Please prioritize your choice with 1st, 2nd 3rd and 4th (鍌鵞術钑b術郠钑 z NatQN N g蜰孊R 鲖;u N(u蹚L垝c廭)Feng Chia University  輨ft~u;m-Em岤^Q{0錧 zNtKNS_鉔媿縍Shih Hsin University  Effective Communication Skills焞悁b鏬The Hong Kong Polytechnic University  Everyday Ergonomics 篘,g緥Tongji University  Built Environment and Urban Culture 鷁b痵僗孴蜽]噀S z/f&T?aa g蜰孊R鲖;u"b INFORMATION OF EMERGENCY CONTACT PERSONEmergency Contact Person抯 name:(in Chinese) (in English) The Relationship of Emergency Contact Person and the applicant:Emergency Phone No.:Emergency Contact Email:Emergency Contact Address:(in both Chinese and English) DeclarationI declare that the information given in support of this application is accurate and complete, and understand that any misrepresentation will lead to disqualification of my application for admission to the Joint University (Summer).I authorize Joint University (Feng Chia University, Shih Hsin University, The University of Macau, The Hong Kong Polytechnic University & Tongji University) to use my data for the following purposes:i) as a basis for all types of processing relevant to my application for admission to the study programmes and for all other associated purposes, including applications/registration, and checking the records of my studies as a student in institutions and the Shanghai Jiaotong University and the ministry of Education, PRC; ii) for the Universities to send me, via e-mail/SMS messages, information concerning my application including shortlist for interview/test and /or admission offer; iii) for the Universities to send me information on the Universities and Departments including programmes on offer; iv) for transferring these data to the student record system upon my admission; v) for using my contact information to maintain on-going communication with me after completion of the Joint University, including the delivery of announcement and other information, such as activities, education programmes, benefits and services; and vi) for statistical and research purposes (where all personal identifiers such as name, ID number, address and telephone number will be deleted). vii) all the information you provide in this form will be used for the Joint University by the organizing universities and the ministry of Education, PRC for administration, health assessment and emergencies. For PolyU students or students applying PolyU subject: viii) The data will be treated in strict confidence and destroyed by PolyU after one year of the activity. Under the Hong Kong Personal Data (Privacy) Ordinance, you may request for access to, and/or correction of your personal data in relation to your participation. If you wish to do so, please write to PolyU Chinese Mainland Affairs Office. ( Yes, I agree. ( No, I don't agree. (Your application will NOT be accepted.)  Undertaking of LiabilityI declare that I participate in the Joint University (Summer) voluntarily, and I am insured against illness, accidents including death and repatriation in case of illness, accident or death during my exchange period.I agree to undertake any risks involved in the programme and I declare that my guardians have been well informed about the details of my participation in the programme.WXhijqr     4 5 6 7 H I J K L s 蹴脊紋黃川灤〞嵈〞磣川磟u〞磣磍磂` ho( h禕hO>h銼hqTCJ h銼o(h銼h禕hqTCJPJnHtHh禕hqTo(h禕hqTCJh禕hqTCJo( joh禕hqTCJ h禕hqT jh禕hqT6h禕hqT6 h禕hwh禕hw5>*CJh禕hqT5>*CJh6HCJaJhh:6乤J"Xij _Dkd[$$If杔敃(1) t1)44 layt禕Dkd$$If杔8(1) t1)44 layt禕d$Ifgd禕 dhgdO>  I J K iDkd$$If杔(1) t1)44 layt禕d$Ifgd禕Dkd$$If杔敃(1) t1)44 layt禕K L \ ] ^ s VWkd$$If杔斣0] (  t1)44 layt禕d$Ifgd禕Dkdl$$If杔(1) t1)44 layt禕 O ^ o z  F H J ~   ( < b f l p r t x 眚嶷於嗣詰サ趹趭嶷vjj`jVh禕h齔y6丆Jh禕h鶤p6丆Jh禕hqT6丆JH*h禕h]zf6丆Jh禕hqT6丆J h禕hk?h禕h [Ho(h禕h [H6丆Jo(h禕hqT6丆JnHo(tHh禕hqT6丆JnHtHh禕hqTo(h禕h1o( h禕h罥T h禕hqTh禕hqT5>*CJ ho( h禕hO> h禕h CWkd$$If杔0] (  t1)44 layt禕d$Ifgd禕WkdT$$If杔70] (  t1)44 layt禕 VDkd$$If杔旘(1) t1)44 layt禕d$Ifgd禕Wkdn$$If杔斅0] (  t1)44 layt禕  $d$Ifa$gd禕d$Ifgd禕DkdV$$If杔8(1) t1)44 layt禕  ( 6 > N oaPa?$d$Ifa$gd禕$d$Ifa$gd禕d$Ifgd禕kd$$If杔8謗q$(B} 4k  t1)44 layt禕N O _ ` a b ttttd$Ifgd禕}kdr$$If杔8謀s (B  t1)44 layt禕b c m n ttd$Ifgd禕}kd+$$If杔旝謀(B  t1)44 layt禕n o J CWkdc$$If杔攱0 ( [ t1)44 layt禕d$Ifgd禕Wkd$$If杔80 ( [ t1)44 layt禕J L | VWkd=$$If杔80 (&   t1)44 layt禕d$Ifgd禕Dkd$$If杔8(1) t1)44 layt禕 CWkd; $$If杔敻0 (&   t1)44 layt禕d$Ifgd禕Wkd$$If杔攜0 (&   t1)44 layt禕 ^PPPd$Ifgd禕kd $$If杔8謗 K%(&  t1)44 layt禕$d$Ifa$gd禕  CWkd $$If杔敧0 (&   t1)44 layt禕d$Ifgd禕Wkd{ $$If杔80 (&   t1)44 layt禕  d$Ifgd嘰kkdy $$If杔敡(1) t01)44 layt禕  ,.024^&(*,翳哂呱魯瑸悈惓}瑅恗琺瑦m琺瑦m琩h禕h]zfCJh禕h>#sCJ h禕h [Hh禕h>#so(h禕h [HOJQJh禕h [HOJQJ^Jo(h禕h;cOJQJ^Jo( h禕h>#sh禕h>#sCJPJnHtH h禕hqTh禕hqT6丆Jh嘰h嘰6丆Jo(h嘰6丆Jo(h禕h]zf6丆Jo(h禕h齔y6丆JH*! .td$If^gd禕d$Ifgd禕kkd $$If杔敃(1) t01)44 layt禕.02sad$If^gd禕d$Ifgd禕~kd $$If杔80(I& t01)44 layt禕(ssd$Ifgd禕~kd $$If杔80(I& t01)44 layt禕(*,sad$If^gd禕d$Ifgd禕~kdY$$If杔80(I& t01)44 layt禕sad$If^gd禕d$Ifgd禕~kd-$$If杔80(I& t01)44 layt禕078 !'(,-8:胥瘴啪搏枻枻彇垨垉垨|杣i漛[Qb jh禕h瓁 h禕h: h禕h瓁h禕h[5>*CJ h禕hO> h'h6H h'o( h禕he$w h禕hNh h禕h6H h禕h[ h禕huE, h禕hh禕h5>*CJ h禕hqTh禕hfrCJ h禕h]zfh禕h闝OJQJ^Jo(h禕h]zfOJQJ^Jo(h禕hOJQJ^Jo(sd$Ifgd禕~kd$$If杔80(I& t01)44 layt禕9:BDkdq$$If杔8(1) t1)44 layt禕d$Ifgd禕kkd$$If杔8(1) t01)44 layt禕:YZtuPkd$$If杔8謗S"$(B_ 7  t1)44 layt禕d$Ifgd禕$d$Ifa$gd禕CWkd $$If杔80 (P  t1)44 layt禕d$Ifgd禕Wkd$$If杔80(Z t1)44 layt禕"#$%5Wkd $$If杔80 ( < t1)44 layt禕d$Ifgd'd$Ifgd禕Wkd$$If杔80 ( . t1)44 layt禕%&'()*+CWkd$$If杔80 ( < t1)44 layt禕d$Ifgd禕Wkd$$If杔80 ( < t1)44 layt禕+,9:"#VDkd$$If杔8(1) t1)44 layt禕d$Ifgd禕Wkd$$If杔80 ( < t1)44 layt禕0H&3Dkda$$If杔擛(1) t1)44 layt禕 X刋>d$If^刋`>d禕 X刋>d$If^刋`>d禕`慲抈醏鉦a8aAaCaDa抋揳絘莂bbbbVbXbhbjb琤産蝏衎郻鈈靊鯤脒鏍秭秭鎦廈睹冬錚檹儚z６６６qd６h禕h慠56>*aJh禕h慠aJh禕h礱faJh禕h$1CJaJo(h禕hOt3aJo(h禕h礱faJo(h禕h瓁aJh禕h瓁6乤Jh禕h瓁56>*aJh禕h瓁56乤J h禕h: h禕hO>Uh禕h瓁5>*CJhO> h禕h瓁 jh禕h瓁$~廯恅gDkd$$If杔8(1) t1)44 layt禕Dkd$$If杔8(1) t1)44 layt禕d$Ifgd禕 I also understand that it is duly my responsibility to make traveling, accommodation and subject selection arrangements for the summer school. ( Yes, I agree. ( No, I don't agree. (Your application will NOT be accepted.) 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