ICAN Application 動漫宣教課程申請

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ICAN Application 原鄉動漫農業創業課程申請

Course Selection : 動漫創業課程有機農業創業課程

Name:

姓名： *

First Last

形式：名字＋姓氏

Date of Birth:

出生日期：

MM / DD / YYYY

形式：月／日／年

Gender:

性別：

Male 男性

Female 女性

Email Address:

電子郵件信箱： *

Phone:

聯絡電話：

Nationality:

國籍：

Other Passports Held:

若持有他國護照請詳列：

Passport Number:

護照號碼：

Passport Expiration Date:

護照期限：

MM / DD / YYYY

形式：月／日／年

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Marital Status:

婚姻狀況：

Married 已婚

Single 單身

Divorced 離婚

Widowed 守寡

Engaged 已訂婚

Re-married 再婚

Spouse's Name:

配偶姓名：

Number of Children Accompanying You:

帶來的兒女人數：

Child 1 Name and Birthday:

第一兒女姓名與生日：


第二兒女姓名與生日：


第三兒女姓名與生日：


第四兒女姓名與生日：


第五兒女姓名與生日：

Permanent Address:

穩定的住址：

Street Address Address Line 2 City State / Province

/ Region Postal / Zip Code

Country / Region

Present Address:

現在的住址：

Street Address Address Line 2 City State / Province

/ Region Postal / Zip Code

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Country / Region

Please upload a profile photo of yourself.

請上傳你本人大頭照一張。

Your Financial Sources:

你的經濟來源：

Family 家人

Personal Savings 個人存款

Enough Fees 費用已足夠

Not Enough Fees 費用不足

Debt or Loan 尚有債務或貸款未償

Church Support 教會支持

Living by Faith 憑信心生活

Highest Level of Education:

最高教育程度：

Emergency Contact:

緊急聯絡人：

First Last


Emergency Contact Phone:

緊急聯絡電話：

Emergency Contact Email Address：

緊急聯絡人的電子郵件信箱:

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These should be the people filling out your references for you:

下列表單應為你的推薦人所填寫：

Pastor's Name:

牧者姓名：

First Last


Pastor's Email Address:

牧者的電子郵件信箱：

Mentor's Name:

輔導或小組長姓名：

First Last


Mentor's Email Address:

輔導或小組長的電子郵件信箱：

In order for us to get to know you better, please prayerfully answer the following

questions. 为了让我们能更多認識您，请禱告然後回答下面的问题。

Describe your conversion experience in three stages.

請依三個階段分別敘述你信主的情況與經歷。

1.) Pre-Christ信主前

2.) Conversion轉捩點(原因與過程)

3.) Present Relationship目前與主的關係如何

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Describe your relationship and experience within your Church.

請敘述你和你的教會之間的關係與配搭狀況。

What are your main motivations for applying to Cartooning and Animation for Missions?

What are your expectations?

你的申請動漫農業課程的主要動機是什麼？你的期望是什麼？

Please describe your history in the field of art.

請描述你的歷史在藝術的領域。

What previous training or experience have you had in art, cartooning or animation?

你有什麼以前的藝術漫畫或動畫的培訓或經驗？

Can you bring any equipment or resources? Do you own your own laptop computer? If so,

please describe (model name, operating system, software, etc.).

你能帶來任何設備或資源？你擁有自己的筆記本電腦嗎？如果有的話，請詳細說明

（型號名稱，操作系統，軟體等）。

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Please check the following areas in which you have skill or experience:

請檢查下面有技巧和經驗的領域：

Cartooning 漫畫

Illustration 插圖

Graphic Design 平面設計

Animation 動畫

Manga/Anime 日式動漫

3D Graphics 三維計算機圖形

Photography 攝影

Sound Design 音響設計

Videography 錄像

Research 研究

Web Design 網頁設計

Music 音樂

Please check the following languages in which you are fluent:

請檢查下面你能說流利的語言：

English 英語

Mandarin Chinese 國語

Cantonese 廣東話

Taiwanese 台語

Japanese 日語

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Thai 泰語

Korean 韓語

Tagalog 他加祿語

Hindi 印地語

Indonesian 印度尼西亞語

Is there anything else you would like us to know about you? Do you have any more

questions, or concerns?

你還有是讓我們知道？你有任何問題或疑慮？

Please upload a minimum of 3 samples of your own artwork.

請上傳自己作的藝術品，最少三樣作品。

Alternatively, you may paste a web address here where we can view samples of your art.

或者，您可以貼網址，在這裡我們可以查看你的藝術的樣本。

Note: Your art samples will not be used as the only criteria for acceptance into the school.

It is simply for us to get to know you as an artist, and assess your artistic level.

注意：你的藝術樣本不能作為唯一入校驗收標準。僅僅讓我們知道您作為一個藝術

家，並評估您的藝術水平。

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CONFIDENTIAL HEALTH FORM

健康記錄表

This information is treated confidentially; please answer the following questions in detail.

下列資料皆為保密處理，請詳加回答

Type of Medical Insurance:

醫療保險類型：

Name of Medical Insurance Carrier:

醫療保險名稱：

Weight:

體重：

Height:

身高：

Any Allergies?

對任何東西或藥物過敏嗎？

Yes 是

No 否

If so please explain:

若是，請詳加說明情況：

Any Physical Disabilities?

有任何身體上的缺陷嗎？

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Yes 是

No 否

Have you ever had, or do you have, any of the following?

你曾經或現在患有下列的病症？

Heart trouble 心臟疾病

Hepatitis 肝炎

Anaemia 貧血

Sexual disease 性病

High Blood Pressure 高血壓

Diabetes 糖尿病

Stomach trouble 腸胃疾病

Cancer 癌症

Shortness of breath 氣喘

Kidney disease 腎臟疾病

Tuberculosis 肺結核

Polio 小兒痲痹

Arthritis 關節炎

Color Blind 色盲

Epilepsy 癲癇

Paralysis 癱瘓

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If you checked any of the above please explain:

請詳加解釋上列你所勾選之項目：

Do any of the following occur frequently?

你是否有下列任何習慣性病症？

Dizziness 昏眩

Headache 頭痛

Medical Nervousness 神經緊張

Insomnia 失眠

Diarrhea 腹瀉

Backache 背痛



Do any members of your family have the following?

你的家族中是否有人曾患下列病症？

Heart trouble 心臟疾病

High Blood Pressure 高血壓

Diabetes 糖尿病

Shortness of breath 氣喘

Kidney disease 腎臟疾病

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Tuberculosis 肺結核

Epilepsy 癲癇

Paralysis 癱瘓



CONSENT AND AGREEMENT

切結書

I/We do hereby release CANADA YOUTH SOCIETY, its agents,

employees, and volunteer assistants from any liability whatsoever arising

out of any injury, damage or loss which may be sustained by said person

during the course of involvement with CANADA YOUTH SOCIETY.

本人同意於加入加拿大青少年協會訓練期間，所遇到非因學校或同工之

過失所致之意外傷害或損失，加拿大青少年協會機構、學校及其負責人

或同工豁免責任。

NOTE: Damage or loss refers to those not caused by the agents and

employees: e.g. earthquake, flood, airplane accidents, drowning, car

accidents, etc.

說明：意外傷害或損失係指非因機構或同工之過失造成，例如：地震、

水災、車禍、或海灘落水、任何墬落或傷害。

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I agree 我同意

I do not agree 我不同意

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CONSENT FOR TREATMENT: I/We hereby agree to the performance of

such treatment, anaesthetics and operations as in the opinion of attending

physician.

醫療權利：本人同意按照醫生之檢查，為我作所需的治療或手術。

*

I agree 我同意

I do not agree 我不同意

I confirm that I understand that payment of the required fees must be

made upon or before my arrival, unless otherwise arranged with

leadership before departure. I further understand that payment must be

made in the currency used by the country in which the school is located, or

in U.S. Dollars. I also confirm that I am fully aware of my financial

obligations. I therefore commit myself to paying all personal expenses

incurred during my involvement with Canada Youth. If I am accepted by

Canada Youth, I will abide by the spirit, rules and schedules of CYAD.

我確知所有學費須在開學前或註冊當天繳納，除非與訓練學校負責人協

商同意之情況下有例外處理。我完全接受繳付所有學費是我的義務，因

此，在我接受訓練期間，我必清還各人學費或其他一切有關學習的費用。

倘若我被接納參加學校的訓練，我必在靈裡完全遵守及服從學校的規定。

* Yes 是

No 否

請 Email : [email protected]

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ICAN Application 動漫宣教課程申請