乐善堂顾超文中学-伊利沙伯中学旧生会中学.DOCVIP

嘉許及獎學金組 / 獎助學金提名申請表 / 頁 PAGE 1 Queen Elizabeth School Old Students’ Association 伊利沙伯中學舊生會中學 Application Form for Scholarship 獎助學金申請表 Part A. Personal Particulars個人資料 Item of application 申請項目： Name of Applicant 學生姓名： (中文) (English) Phone 聯絡電話： Class 班別： （　　） Age 年齡： Gender 性別： Part B. Participation in Extra-Curricular Activities 校內及校外參與活動 Name of Student Organization/ Organization/Activity 學生組織/組織/活動名稱 Year 參與年份 Position held/ Nature of activity 擔任職位/活動性質 Part C. Awards/Scholarships Received 曾獲獎學金/獎項 Scope 範圍 Name of Award/Scholarship 獎學金/獎項名稱 Year 年份 Organization 頒發機構 * Please use supplementary sheets if necessary. 若以上表格不敷應用，請按表格編排，另加紙張。 Part D. Academic Performance學業表現 D1. Academic Year 學年：_________________ （上學期考試／學年試 [科目及其分數] 1st Term Exam / Final Exam [subjects and marks]） 中文 English Maths D2. Best Form rank / Class rank in last two years 兩年內最佳級名次/班名次 （Form rank which is above 50th only. 只須填寫全級五十名以內名次； 　Class rank which is above 10th only. 只須填寫全班十名以內的名次） Year 年份 1st Term Exam 上學期考試 Final Exam 學年試 Whole year 全年 Part E. Reason(s) of Application申請理由 Please use 200-300 words to describe the reason(s) why you apply for this scholarship. 請用約200-300字簡述為何你值得獲取本獎助學金。 ** Please use supplementary sheets if necessary. 如有需要，請另加附頁填寫。 Part F. Declaration 聲明 I (name) have obtained and read the guidelines of the scholarship stated above. I confirm that I completely understand and comply with them. I declare that all information given in this application is fully comprehensive and correct. 本人 (姓名)已閱讀以上所申請獎助學金的指引，並且完全明白和同意遵守當中所有內容。本人謹此聲明報名表格的資料真實無訛。 Signature 簽署: Date 日期: Interview Assessment Result面試及批核結果 Performance of Applicant申請人面試表現： Result 批核結果： FORMCHECKBOX Rejected 不予批准 FORMCHECKBOX Approved 批准： Teacher-in-charge: 負責老師： Signature 簽署： Date 日期： Part G. Referee’s Comments 諮詢人評語 G1. Applicant’s information (to be completed by the applicant) 申請學生基本資料（本部分由