候選人提名表格.docVIP

2010年坪洲鄉事委員會街坊代表選舉 2010 Peng Chau Rural Committee Kaifong Representative Election 提名表格 NOMINATION FORM [請用正楷及英文大楷填寫此提名表格及參閱填寫提名表格說明] [You should use BLOCK LETTERS in completing this Nomination Form and read carefully the attached Notes on Completion of a Nomination Form.] 第一部份: 提名 Part I NOMINATION 第一節: 候選人資料 (由候選人填寫) (請參閱說明第4及15項) Section 1: Particulars of Candidate (to be completed by candidate) (Please refer to Notes 4 and 15) 中文姓名: Name in Chinese :_______________________________________(__________________) (別名Alias) 中文電碼: Chinese Commercial Code:________ _______ _______ _______ _______ _______ 英文姓名: English Name:____________________________________________________________ (姓Surname) (名Other name) (別名Alias) 香港身分證號碼: Hong Kong Identity Card Number:____________________________________________ 出生日期: 性別 Date of Birth:______________________ Sex:______________________ (日dd/ 月mm/ 年yyyy) 職業: Occupation:________________________________________________________________ (英文in English) (中文in Chinese) 公司/機構名稱: Name of Company/Organization:_______________________________________________ 主要住址(中文): Principal Residential Address in Chinese: ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ 主要住址(英文): Principal Residential Address in English:_________________________________________________________ __________________________________________________________ __________________________________________________________ 電話號碼 住宅 辦公室 Telephone Numbers: Home _______________________ Office ____________________ 流動電話 傳呼機 Mobile ______________________ Pager _____________________ 供傳媒聯絡的電話號碼: C