Home-stay in Jinhua`s Historical Villages
海外名校走进金华古村落申请表 Home-stay in Jinhua’s Historical Villages The application pack consists of two parts: Part 1 – Application form Part 2 – Letter of application Part 1 – Application form 姓 名 Given name Surname 家庭地址 Permanent address 学校名称 School / organisation 国 籍 Nationality 姓 别 Sex 手机号码 Mobile phone number 家庭电话 Landline number 邮箱地址 Email address 项目：请选择你所申请的任务, 按照 1-5 顺序标出，1 为倾向性 最 高 ， 5 为 倾 向 性 最 低 Task (Please list in order of preference 1=high, 5=low) 是否参加过类似活动，如果是请 填写日期和之前项目主办的联 系 方 式 Have you previously participated in a similar event? If yes, please indicate the date and the sponsor's contact details. 是否愿意和其他参与者合住 Are you willing to share your accommodation with other participants? 出生日期 Date of Birth □ 制作宣传资料 Production of promotional material □ 攒写宣传文章 Production of promotional essay □ 设计样版类 Design of accommodation model □ 设计网站 Design of website □ 拍摄宣传照或绘制写生等 Artworks (inc. photography). Specify type of artwork ______________________ □是 Yes □是 Yes □否 No 15 □否 No 是否有海外旅行经验，若有，请 Do you have any 描 述 experience of travelling abroad? If yes, please describe it. 母语 Native language 外语 Other languages spoken (please state level) 是否有任何健康问题，例如过 敏，是否希望你入住的家庭知道 Please, list your health problems (if any), including allergies, and specify if you need the host to know them. List any medications you are taking. 是否有任何饮食禁忌，是否希望 你入住的家庭知道 Please list any nutritional or dietary limitations, and specify if you need the host to know them. 你的兴趣和爱好 Hobbies and interests Session preferred (please tick) □ First session: 22 June – 12 July 2015 □ Second session: 12 October – 1 November 2015 If your first preference session is not available, would you be able to take part in the other session? □ Yes □ No I have read, and agree to, the terms and conditions for participation in the project. 申请人签名 日期 Applicant's signature Date 16 海外名校走进金华古村落项目 Home-stay in Jinhua’s Historical Villages Part 2 – Letter of application 申请表 2 We are offering participants a unique opportunity to experience Chinese village life, and to learn about traditional Chinese culture. In return, we are keen to hear your perspective on how to develop village home-stay tourism, and your ideas on how to protect and preserve our ancient villages. 我们为广大的参与者提供了一个体验中国古村落文化，了解中国传统文化的绝佳机会。 相应地，我们很乐于倾听你们在如何发展中国古村落旅游、保护古村落文化方面的见 解。 Person specification 申请人资质 We are looking for participants with the following attributes.我们正在寻找具有以下资质 的人员 Essential 基本要求 An eagerness to learn about other cultures. 渴望了解他国文化 The ability to communicate sensitively with people from different backgrounds. 具备能自如地与来自不同文化背景的人员打交道的能力 The ability to cope successfully in a variety of living conditions. 较强的居住适应能力 Flexibility, for example to overcome any difficulties, or adapt if plans need to be changed. 较强的抗压能力和灵活变通的能力 The ability to work as part of a team. 团队合作能力 Desirable 具备以下任意条件者优先考虑 An interest in, or experience of studying, either: Chinese traditional culture, historical buildings and/or folk customs.研究中国传 统文化、历史建筑、民俗文化或者对以上几项感兴趣的 or aspects of another traditional culture different from your own.研究非本国文化 之外的传统文化产业或者对此感兴趣的 or the travel and tourism industry.研究旅游产业或者对此感兴趣的 17 Letter of application 申请信 Please outline why you are interested in taking part in the project, and give examples to show how you fulfil the requirements of the person specification. Please outline how your skills match the task/s you wish to work on. 请写明你对此项目感兴趣的原因，并提供与项目要求相符的个人资质，例如写清楚你 具备哪些技能能很好地服务于这个项目。 If possible please attach, or provide a link to, an example of your work. For example, if you want to produce a promotional essay, attach or provide a link to a piece of your writing. If want to work on website design, include a link to a website you have previously designed. If you want to produce artworks, attach or provide a link to examples of your work. 请提供一些能证明你资质的参考资料。例如：如果你想撰写宣传文章，请提供相应的 链接，能让我们能看到你以往写的文章；如果你想从事网站设计，请提供你以前设计 过的网站供我们参考；如果你想创作艺术品，请让我们看到你以往设计过的作品。 Please write no more than two pages (A4 / letter size). 字数请控制在两页纸以内。 请尽早将以上表格发至组办方邮箱，以便和同期来参加活动的国际学生相匹配。 In order to make the necessary arrangements in good time, please forward your application to the organisers as soon as possible. The closing date is 15APR&31JUL(1st&2nd Session) 18 Liability agreement I understand and agree that neither the Foreign and Overseas-Chinese Affairs Office of Jinhua Municipal People's Government nor its agents and employees (hereinafter referred to as “Released Parties”) may be held liable or responsible in any way for any occurrence which may result in personal injury, property damage or wrongful death or other damages to me, my family, estate, heirs, or assigns that may occur as a result of participation in the project "Home-stay in Jinhua’s Historical Villages"or as a result of the negligence of any party, including the Released Parties, whether passive or active. I further state that I am of lawful age and legally competent to sign this Liability Release Agreement, or that I have obtained the written consent of my parent or guardian. I understand the terms herein are contractual and not a mere recital, and that I have signed this Agreement of my own free will and with the knowledge that I hereby agree to waive my legal rights. I further agree that if any provision of this agreement is found to be unenforceable or invalid, that provision shall be severed from this agreement. The remainder of this agreement will then be construed as though the unenforceable provision had never been contained herein. I understand and agree that I am not only giving up my right to sue the Released Parties but also any rights my heirs, assigns, or beneficiaries may have to sue the Released Parties resulting from my death. I further represent I have the authority to do so and that my heirs, assigns, and beneficiaries will be estopped from claiming otherwise because of my representations to the Released Parties. I acknowledge that a medical insurance contract bought by myself is compulsory and that any medical expenses have to be covered by myself. Name of the applicant _____________________________________________________________ Date __________________________ Signature ______________________________________ 19 Media consent form I hereby consent to the participation in interviews, the use of quotes, and the taking of photographs, movies or video tapes of myself by Foreign and Overseas-Chinese Affairs Office of Jinhua Municipal People's Government, its agents and employees as well as any media reporting on the project "Home-stay in Jinhua’s Historical Villages". I also grant the right to edit, use, and reuse said products for purposes of furthering the cause of the project, including use in print, on the internet, and all other forms of media. I also hereby release the Foreign and Overseas-Chinese Affairs Office of Jinhua Municipal People's Government and its agents and employees from all claims, demands, and liabilities whatsoever in connection with the above. Name of the applicant _____________________________________________________________ Date __________________________ Signature______________________________________ Copyright release form I hereby consent grant permission to Foreign and Overseas-Chinese Affairs Office of Jinhua Municipal People's Government and any related agencies any artwork, design, photographs, or texts produced by me during the my participation in the project "Home-stay in Jinhua’s Historical Villages" for the purpose of furthering the cause of the project, which can include, but is not limited to, websites and print publications without any further compensation or recognition given to me. I grant creative permission to alter or edit any of the works mentioned above. I do not grant permission to resale or use the works mentioned above in a manner that would exploit or cause malicious representation toward me. My rights to use any of the works for self-promotion or to grant further rights of use to third parties are not restricted in any way. Name of the applicant _____________________________________________________________ Date __________________________ Signature ______________________________________ 20 紧急情况联系和学生过敏表 Emergency Contacts& Allergies Declaration Form Emergency Contacts 假如出现紧急情况时，父母无法联系上，请填写至少一名其他联系人： In case of emergency, what contacts should be reached other than the parents? 1． 名字 Name _____________________ 电话（家） Phone ___________________________ （手机）Mobile ___________________ 邮箱 e-mail_________________________________ 2． 名字 Name _____________________ 电话（家） Phone ___________________________ （手机）Mobile __________________ _邮箱 e-mail_________________________________ Allergy Declaration 过敏源：Allergic agent: 症状：Symptoms 治疗办法：Treatment: _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ *如果需处方药物治疗或者超出 （the counter medications）,必须提供适当的药物治疗书面授权和内科医师签 字 。 If particular prescriptions or counter medications are needed, it is necessary to provide the relevant written authorization for medication signed by the physician. 过敏症是否接受过医生诊断？Was any of the allergies treated in the past? 是 Yes □ 不是 No □ 如果是，我们需要一份医生开出的病历复印件作为文件存档。If yes,the clinic report signed by the physician is requested. 更多紧急情况反应 Other emergency reactions 过程：Course _____________________________________________________________________________________ _____________________________________________________________________________________________ _________________________________________________________________________________________ 我理解主办单位需要我孩子到目前为止的所有过敏信息。我同意为了我孩子的安全，我孩子过敏信息将被张 贴在总部及食堂的过敏史告知表上。 I understand the reasons why the sponsor needs to collect the applicant's information. For the safety of my child, I agree on having the information about his/her allergies posted on the allergy information window of the cafeteria. 申请人签名 日期 Applicant's signature Date 第 1 页 共 1 页
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