“i-Relay” Youth Integrity Project2013/14

Recruitment of ICAC Ambassadors

The Hong KongUniversity of Science and Technology

Enrolment Form

Please fill in the following information and returnto HKUST Connect at Room 5016 (Lift3), AcademicBuilding, HKUST orvia email to connect @ust.hk on or before 23September 2013. For enquiries, please contact Miss Mavis HO (Service Learning Co-ordinator, HKUST Connect) byphone: 2358 5850 oremail: .

A. Personal Particulars

Name: (English) / (Chinese) / (Preferred name)
Student ID: / Gender: / D.O.B.(dd/mm/yy)
Faculty/School/Academy: / Major:
Year of Study: / Year of Graduation:
Email (School):
Email (Personal):
Mobile Phone:
Correspondence Address:

B. Other Information

1.Are you going to join overseas exchange programme in 2013/14 academic year?

Yes, period: /  No
  1. Did you join the ICAC Ambassador Programme in previous years?

Yes, position held: /  No

3.The talents/experiences you possess which may facilitateyour involvement in “i-Relay” Youth Integrity Project (may choose more than one):

 Programme Planning /  Marketing/Promotion of event
 Participation in/organisation of Exchange Programme /  MC of event
 Design /  Photography
Performance [e.g. singing, dancing, drama, musical instrument(s), etc; please specify]:
 Computer skills (please specify):
 Others (please specify):
  1. Language Skills

Items / Excellent / Good / Fair / Poor / N/A
Spoken / Cantonese
Putonghua
English
Written / Chinese
English
Others (please specify):
  1. Are you able to join the following activities?

-Information Session [11 Sep 2013,6:30pm] Yes No

- Selection Interview*[11 Oct 2013] Yes No

-Input Session+[9Nov2013 (Sat) (am)] Yes No

- ICAC Ambassador Training Camp+[9 and 10Nov 2013 (Sat –Sun)] YesNo

Important Notes:
* Short-listed candidates will be invitedto attend the selection interview.
+ Selected Ambassadors are required to attend theInput Sessionand ICAC Ambassador Training Camp.
  1. Records of extra-curricular activities or community services in the past two years

Year / Activity / Position Held/Involvement

(Please attach additional sheet if necessary)

  1. Are you interested in joining the team competition of the “i-Relay” Youth Integrity Project?(Participants are required toform teams and submita marketing plan on promoting youth integrity, or a project-based report on topics related to youth ethics, money management and a fruitful life. For details, please refer to .)

 Yes No

8.Please use around 200 words (in English or Chinese) to write down “Why do you deserve to be selected as the ICAC Ambassador?” Please also share your ideas on how topromotethe team competitionof the “i-Relay” Youth Integrity Project to your fellow schoolmates.

(Please use a separate sheet tosubmit)

Signature: / Date:

The information provided in this form will be used for processing your application for joining the above programme. Under Sections 18 and 22 and Principle 6 of Schedule 1 of the personal Data (Privacy) Ordinance, you have the right of access to make correction of your personal data provided in this form. Such access to personal data should be addressed to HKUST Connect. This form will be kept until1 August 2014.

*****