2013请表伊利请表伊利沙伯女皇弱智人士基金拨款申.docVIP

伊利沙伯女皇弱智人士基金撥款申請表 Application for a Grant from Queen Elizabeth Foundation for the Mentally Handicapped (QEFMH) 擬議計劃Proposed project 計劃名稱 Project name(最多廿五字) (in 25 words maximum) (中文) (in Chinese) (必需填寫required) (英文) (in English) (必需填寫required) 申請的計劃Scheme applied (please tick the appropriate ONE) (必需填寫required) 每張申請表只可提交一個計劃Please use separate form for EACH scheme ? 智障人士高齡化服務支援計劃 (申請資助額為港幣$20,000至$100,000) 請答第(i)項 Please go to item (i) Scheme to Support Aged Persons with Intellectual Disability (Amount of grant applied should be from HK$20,000 to HK$100,000) ? 獨立生活設備支援計劃 (申請資助額為港幣$20,000至$50,000) 請跳答第(ii)項 Please go to item (ii) Scheme to Support Persons with Intellectual Disability for Independent Living Facilities (Amount of grant applied should be from HK$20,000 to HK$50,000) ? 一般資助計劃 (申請資助額為港幣$30,000以上) 請跳答第(iii)項 Please go to item (iii) General Support Scheme (Amount of grant applied should be above HK$30,000) 計劃性質 Nature of proposed project (i) 智障人士高齡化服務支援計劃的性質(請選出最適切的一項) Nature of Scheme to Support Aged Persons with Intellectual Disability (please tick the most appropriate one) : ? 購置器材、設施purchase of equipment/facilities( ? 康復rehabilitation ? 訓練training ? 資訊科技、電腦IT, computer ? 康樂recreation) ? 小型工程minor capital works ? 服務及訓練service and training ? 公眾教育public education ? 康樂leisure and recreation (ii) 獨立生活設備支援計劃的性質(請選出最適切的一項) Nature of Scheme to Support Persons with Intellectual Disability for Independent Living Facilities (please tick the most appropriate one) : ? 購置器材、設施purchase of equipment/facilities( ? 康復rehabilitation ? 訓練training ? 資訊科技、電腦IT, computer ? 康樂recreation) (iii) 一般資助計劃的性質(請選出最適切的一項) nature of General Support Scheme (please tick the most appropriate one) : ? 購置器材、設施purchase of equipment/facilities( ? 康復rehabilitation ? 訓練training ? 資訊科技、電腦IT, computer ? 康樂recreation) ? 小型工程minor capital works ? 服務及訓練service and training ? 公眾教育pu