启行国际营2013报名表 IDEAS 2013 International Camp Application Form
* 填表语言必须为英文 Please fill out this application form in English.
1.个人信息 Personal Information
姓名 Name (格式：姓/名 Format：Family Name/Given Name) *
性别 Gender *
出生信息 Birth MM/DD/YYYY *
国籍 Nationality *
你居住地国家 Country of Residence *
你居住地城市 City *
固定电话 Tel (Format: Country code-area code-telephone number, e.g. 0086-10-88888888；00886-2-88888888；001-604-7777777) *
手机号码 Mobile Number (Format: Country code-telephone number, e.g. 0086-13911111111；00886-912312312；001-7777777) *
联系地址 Address (Format: Room, Unit, Building, Road, District, City, Prov/State, Country) *
邮编 Zip code/Postal code *
E-mail （重要信息：所有通知将会发送到以下提供的电邮邮箱中 Important: all notifications will be sent to the email address provided below） *
你是否有任何已知的健康问题或抗药及过敏反应？Do you have any health issues of which the camp or medical staff should be aware? *
*如果在活动期间营员需自行照顾个人健康，如需协助，请尽早联系工作人员 Campers need to pay attention to their own health during the summer camp. Please inform our staff if you need special attention or assistance.
你在饮食方面有什么特殊要求? Do you have any special requirement of diet? *
2.活动信息 Camp Programs
您想参加哪一场营会活动？Which camp would you like to join? *
*每人仅能报名一场 You can apply for ONLY ONE camp
如果你选择的第一志愿营会活动未能入选，请在以下选择你的第二志愿营会活动 What is your secondary preference： *
您是如何了解到启行夏令营的信息？How do you know about IDEAS 2013 Summer Camp? *
您是否以后想收到我们的活动信息？Do you wish to receive IDEAS newsletter? *
您是否在2013年（仅此年）参加了A-action青少年公益创想行动？如有，请填写项目名称。Did you participated A-action in the year of 2013 (Only for this year)？If "Yes", please provide the project name. *
3.背景 Background
请选择你接受教育的方式？ Please indicate your form of education *
如果你在上一题中选择「学校」一项，请填写学校名字及年级（格式：学校名字/年纪） If you have selected "Public/Private School" above, please provide school name and Grade level （Format: School name/Grade)）: *
(续上题) 学校所在国家及城市 (格式：国家/城市) The country and city where the school is located （country/city）: *
英文水平 English skill
你在日常生活中使用的语种（如：中文）What language do you use mostly? (e.g. Chinese) *
如有参加以下标准考试，请对应提供成绩（可多选）Please provide scores of the following standardized tests, if applicable *
4.自我介绍 Short Answers and Essays
以下部分内容，请用英文填写。不以英文填写的内容，将不予采纳。Please use English ONLY to answer the following questions.
1. 请列出您的课外活动 （不同活动请用“；”分隔） Please briefly list your extracurricular activities （use ";" to separate different activities） *
2. 您希望从这次夏令营获得什么成长？What do you hope to gain from joining IDEAS Summer Camp 2013? *
最多300字 Maximum 300 words
3. 你对自己哪个特质最满意？What is the most outstanding quality you have ? *
请用最多300字进行描述 Maximum 300 words
4. 您做过最有意义的社会实线活动是什么？Please briefly elaborate on the most meaningful social activities you have participated in. *
最多300字 Maxmuium 300 words
5. 在你现在（或过去）所在的团队中，你最长担任的角色?（如：执行者；领导者；调研员；评论者; 等）你如何定义这个角色对团队的作用？What role do you serve the most in your team (e.g. creator, producer, coordinator)? How has your role helped the team? *
6. 在未来的团队里，你希望自己能担任哪种角色？你准备怎么做好这个角色？In future teams, what role do you wish to serve and how do you plan to serve it? *
7. 您最关注的社会议题是什么？请讨论一下它对你的重要性？What social issues concern you the most? Please discuss its importance to you. *
8. 如果你还有任何其他想与我们分享，请详述 If there is anything else you would like to share with us, please elaborate.
5.声明 Statement
关于个人信息 About Your Personal Information *
我允许启行营地发展中心内部使用我的资料。我明白启行营地发展中心将不会在未经你个人允许的情况下售卖、转发或租借你的个人信息给第三方。
我确保在申请表中提供的信息正确无误,如有错误我本人将负担全部责任。
I give permission to IDEAS Center to use information for internal use. I understand that IDEAS Center will not sell, distribute or lease my personal information to third parties without my permission or are required by law to do so.
I affirm that the information provided in this application is accurate to the best of my knowledge, and that I take full responsibility for any misinformation that occurs.