Hong Kong Radio Amateurs' Examination ( Written Examination )

20130713

http://www.radio.edu.hk/writtenexam.htm

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香港專業教育學院(青衣分校)
HONG KONG INSTITUTE OF VOCATIONAL EDUCATION (TSING YI)
業餘無線電考試 – 報名表
APPLICATION FOR RADIO AMATEURS' EXAMINATION
在填寫此表格前，請先閱讀以下附註:
Please read the NOTES below before completing this form:
1. 此表格內甲、乙兩部份之各項目均須詳細填寫。英文請用正楷書寫，並請在適當方格內以[√]作為標記。
All parts (A&B) in this form should be typed or completed clearly in black ink and BLOCK LETTERS. Please put a tick “√” in the appropriate box(es).
2. 每位申請考生只能遞交一張表格。
Please use one form for each application.
3. 報名費用為港幣350元正。
Application fee is HK$350.
4. 填妥的表格，請連同身份證明文件副本(香港身份證或護照)，及港幣350元正的劃線支票(抬頭人為「香港專業教育學院(青衣分校)」)，於報考截止日期前一併寄往香港青衣島青衣路二十號香港專業教育學院(青衣分校) C350室工程系收。信封面請註明「香港業餘無線電考試」。
The completed application form should be submitted, by post, together with (i) a copy of the Hong Kong Identity Card or Passport and (ii) a crossed cheque of HK$350, made payable to “Hong Kong Institute of Vocational Education (Tsing Yi)”, to Rm. C350, Department of Engineering, Hong Kong Institute of Vocational Education (Tsing Yi), 20 Tsing Yi Road, Tsing Yi, Hong Kong. Please mark "HKRAE" on the envelope.
5. 報考截止日期為考試日期前十四天。逾期的申請，恕不受理。考試日期可查閱網頁：http://www.radio.edu.hk
All application should reach the Institute in fourteen days before the date of examination. No application will be accepted after the deadline. Date of Examination is available at website: http://www.radio.edu.hk
6. 申請人如希望本學院以書面確認收妥其報名表，可提供已付足夠郵資及清楚填寫地址的回郵信封，以便本院辦理。
Candidate who wishes to receive written acknowledgement of his/her application should provide a stamp-affixed and self-addressed envelope for processing of his/her request.
7. 如有任何查詢，請致電2436 8641 / 2436 8642；有關考試之細節，則請致電2436 8651。(工程系，無線電科技中心)
For general enquiries, please phone 2436 8641 or 2436 8642. For enquiries on details of the examination, please call 2436 8651. (Wireless Technology Centre, Department of Engineering)
8. 考試結果將會於考試後一個月內公布。本學院會以書面形式通知各考生其成績。合格的考生，可攜同該信函親往電訊管理局申領執照。
Examination results will be announced within one month after the written examination. The Hong Kong Institute of Vocational Education (Tsing Yi) will issue a letter of result to every candidate. Those who pass the examination may bring the letter to the Office of Telecommunications Authority to apply for the license.
9. 考生如因私人事故，未能出席考試，已繳交的考試費用，一概不獲發還。
All paid application fees are normally non-refundable.
10. 本學院保留權利拒絕接受任何考試申請，及取消考試，在此等情況下，已繳交之考試費用可獲發還。
IVE reserves the right to accept or reject any application, and to cancel the examination. In this case, the examination fee will be refunded. Otherwise, all fees are non-refundable.
11 透過本表格提供的個人資料，全屬自願性質。若你沒有提供足夠資料，本學院可能無法辦理你的申請。
The provision of personal data by means of this application form is voluntary. If you do not provide sufficient information, we may not be able to handle it.
12. 你所提供的個人資料，只會被用以處理你的申請，並可能會披露給其他與評審申請有關的部門/機構。
All data will be used for processing your application only. The personal data you provide may be disclosed to other departments/organizations in connection with the assessment of your application.
13. 資料提供後，你有權要求查閱和改正你的個人資料。你查閱資料的權利包括取得本申請表上所載個人資料的副本，惟索取這些資料時或須繳費。
You have a right of request for access and correction with respect to your personal data after submission of this application form. Your right of access includes the right to obtain a copy of your personal data provided by this application form, though a charge may be levied on obtaining such information.
14. 如想提出查閱和改正個人資料的要求，請以書面聯絡工程系系主任。地址: 香港青衣島青衣路二十號C350室，香港專業教育學院(青衣分校)工程系
Request for access to and correction of personal data should be directed to the Head of Department, at address: Rm C350, Department of Engineering, Hong Kong Institute of Vocational Education (Tsing Yi), 20 Tsing Yi Road, Tsing Yi, Hong Kong.
如在此表格中作虛構陳述，則本院可能會拒絕台端的申請。
Any false statement made in this form may lead to the rejection of your application.
如在獲電訊管理局局長發給牌照之前擁有、設立或使用任何無線電裝備即屬違法。
It is an offence to possess, establish or use any radio equipment before an appropriate licence is granted by the Telecommunications Authority.
甲欄
PART A :
申請人資料
PARTICULARS OF APPLICANT
本欄不必填寫
For Official Use Only
1. 姓名(先生/女士*)
Name (Mr/Ms*)：
中文(Chinese) 英文-姓氏先行(English - Surname first )
2. 中文電碼
Chinese Character Code:
3. 香港身份證號碼/護照號碼*
H.K. Identity Card No./ Passport No.*:
簽發機構 簽發日期 (日/月/年)
Issuing Authority: Date of Issue (DD/MM/YY): / /
4. 通訊地址
Correspondence Address:
5. 電話號碼 (住宅/手提) 電話號碼 (辦公室)
Telephone No.(Home/Mobile): / Telephone No.(Office):
電郵地址 圖文傳真
E-mail Address: @ Fax No.:
6. 請選擇考試語言 中文試題 (Paper in Chinese)
Choice of Language for Examination: 英文試題 (Paper in English)
7. 可選擇是否填寫(Optional)
你是否殘疾人士? 是 否
Are you an applicant with a disability? Yes No
如為殘疾人士，請註明殘疾性質及程度，以便作出適當的考試安排：
If Yes, please indicate the nature and degree of disability to facilitate arrangement of examination:
* 請刪去不適用者 Please delete as appropriate
考試日期
Examination Date:
/ /20
考生編號
Candidate No.:
考試成績
Examination Result:
收據號碼 /
Receipt No./
繳費日期
Date:
/ /20
主考官簽名
Examiner Signature:
職級
Rank:
乙欄 :
PART B :
申請人聲明
DECLARATION OF APPLICANT
致:香港專業教育學院(青衣分校)工程系
To : Hong Kong Institute of Vocational Education (Tsing Yi), Department of Engineering
茲聲明本人在此表格內所提供的資料均屬真實及正確。
I hereby declare that the particulars given by me in this application form are true and correct.
申請人簽名 日期 (日/月/年)
Signature of Applicant: Date (DD/MM/YY): / /20

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