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JA Youth Smart Finance Program Application Form 2022/23
Please complete this form and submit to JA.
請填妥以下表格，並交回JA。
If you require any assistance, please contact JA HK at 3426-3142 or financial.literacy@jahk.org
如有任何查詢，請致電3426-3142或電郵至 financial.literacy@jahk.org
與JA HK聯絡。
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* Indicates required question
School Information 學校資料
English Name 英文名稱
*
Your answer
Chinese Name 中文名稱
*
Your answer
English Address 英文地址
*
Your answer
Chinese Address 中文地址
*
Your answer
School Tel 學校電話
*
Your answer
School Website 學校網址
Your answer
Head of School 校長
English Name 英文姓名
Surname 姓
*
Your answer
First Name 名
*
Your answer
Chinese Name 中文姓名
Your answer
Email Address 電郵地址
*
Your answer
Office Tel. No. 辦公室電話
*
Your answer
Link Teacher 負責老師
English Name 英文姓名
*
Sal 稱呼
Mr
Ms
Mrs
Dr
*
Surname 姓
Your answer
*
First Name 名
Your answer
Chinese Name 中文姓名
Your answer
Position 職位
*
Your answer
Link Teacher Office Tel No. 負責老師辦公室電話
*
Your answer
Mobile No. 手提電話
*
Your answer
Email Address 電郵地址
*
Your answer
Contact Person (if not the same as the Link Teacher) 聯絡人 (如與負責老師不同)
English Name 英文姓名
Your answer
Position 職位
Your answer
Office Tel No. 辦公室電話
Your answer
Mobile No. 手提電話
Your answer
Email Address 電郵地址
Your answer
Expected number of participating student 預算參與學生人數
*The program targets to serve ethnic minority students. If there're some non-EM students, please state clearly the number of non-EM students.
計劃的服務對象為少數族裔學生。如果有非少數族裔學生參加，請清楚列出非
少數族裔學生
的人數。
*Minimum 25 students per class 每班最少25位學生
Form 3 中三
Number of Student 學生人數
Your answer
Form 4 中四
Number of Student 學生人數
Your answer
Form 5 中五
Number of Student 學生人數
Your answer
Form 6 中六
Number of Student 學生人數
Your answer
Preferred Program Schedule 課程日期及時間
*Schools may choose any of the weekday or Saturday in October 2022 - February 2023
學校可選擇2022年10月至2023年2月之間的平日
或
周六
*Workshop duration is 1.5 hours
課程為1.5小時
Preferred Workshop Date & Time 課程舉行日期及時間
*
First Choice 第一選擇
Your answer
Preferred Workshop Date & Time 課程舉行日期及時間
Second Choice 第二選擇
Your answer
Preferred Workshop Date & Time 課程舉行日期及時間
Third Choice 第三選擇
Your answer
Declaration 聲明
I declare that the information given in this application is true and accurate, and confirm that this application has been endorsed and supported by the school. I hereby authorise Junior Achievement Hong Kong (JA) to contact relevant parties and verify information given in this application form.
本人聲明此申請表格內之資料屬實及準確，並確定此申請已得到校方認可及支持。本人謹此授權青年成就香港部與有關人士聯絡，核實申請表格內之資料。
Notes 備註：
* JA reserves all rights to change the workshop dates. JA 保留權利更改工作坊日期
* Please print a copy of this completed form for your record before submitting this form. 遞交前，請先列印已填妥的申請表以作記錄。
I totally understand and accept the statement as above. 本人完全明白及同意上述聲明。
*
I totally understand and accept the statement as above. 本人完全明白及同意上述聲明。
How do you know about this program? 從哪渠道得知此課程？
*
Your answer
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