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Young Skilled Migrant Welfare Council Sydney Institute of Foreign Studies 悉尼多元文化語言學院 2009 年海外华裔及港澳台地区青少年 “中国寻根之旅”夏令营登记表姓名外文姓名（护照名）性别照片出生年月日出生地国籍祖籍现侨居国身高体重胸围腰围护照号码居留证号爱好及特长忌讳过敏药物血型文化程度来自社团或就读院校中文学习情况曾学习何种中文教材（）第几册（）父母情况夏令营活动愿望父亲姓名从事职业母亲姓名从事职业通讯地址国外电话及传真国内联系人（电话）电子邮件宗教信仰父母意见签名：年月日食宿费全免機票統一訂購參觀門票全免培訓費用全免報名費 $75 (每位) 簽證費約$30，自己辦理或統一代辦均可旅遊保險請自購飛機途中保險及附加保險其他如需悉尼地區送機接機，$30每程每人 DONATION / GIFT CARD My gift to The Sydney Institute of Foreign Studies is enclosed. □$50 □$100 □ $150 □$200 □$250 □$300 □ $350 □$400 If your donation is more than $400 in one time, please make cheques payable to SIFS. Perpetual gift arrangement Please deduct $_______ from my credit card until further notice. Monthly □ Bi-monthly□ Quarterly □ Bi-annually□ Annually□ I would like to join YSM Association and pay Membership Fee: 1 year $10 □ 3 years $15 □ 5 year $30 □ Please detatch and return the completed registration form. Thank you for your contribution! 工作人員專用 Office Use Only 收据编码: _________________________ 日期: _________________________ 经手人签名: ______________________ 2

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