格伦家族基金会（海南分会）帮助计划志愿者申请表Glenn Family Foundation (Hainan Branch) HELPS Programme Volunteer Application Form

感谢您花时间申请格伦家庭基金会(海南分会)的帮助计划。由于我们的项目招生人数很少(每项活动大约10人)，我们不能保证每个人都有机会。但我们一定会将您的信息存档，如果有适合您的活动可用，我们会通过您提供的联系方式联系您。Thank you for taking the time to apply to Glenn Family Foundation (Hainan Branch) HELPS Programme. Because our programme intake is small (around 10 per event) we cannot guarantee that we will have an opportunity available. But we will certainly keep your application on file and approach you if something becomes available that is a good match for you.

:申请人详细信息 APPLICANT DETAILS

Q1:姓名 Name（中文）

Q2:姓名 Name（English）

Q3:性别 Gender

男

女

Q4:出生日期 Date of Birth

日期

Q5:国籍 Nationality

选项1

Q6:英文语言能力 English Language proficiency

母语 Native

优秀 Advanced

中间级别 Intermediate

基础水准 Basic

完全不会 None

Q7:手机号码 Mobile Phone

Q8:邮箱 Email

Q9:公司或学校名称 Company or School Name

选项1

Q10:所属行业或专业 Industry or Major

选项1

:分割线

:紧急联系人 EMERGENCY CONTACT

Q11:姓名 Full Name

Q12:关系 Relationship

选项1

Q13:联系电话 Contact Number

Q14:备用电话 Alternative Number

:分割线

:下面是您可能感兴趣实现的项目的一般列表。勾选所有您想尝试并感觉能够做到的事情。Below is a general list of what kinds of projects you might be interested in implementing. Tick all those you would want to try and feel able to do.

Q15:教育 Education

英语教学或辅导 Teaching English or tutoring

阅读研讨会和移动图书馆 Reading workshops and mobile libraries

数字化教学 Digital learning (using tablets and downloadable content as teaching aids)

计算机教学 Computer teaching

帮助青少年接受职业教育 Helping youth access vocational studies

其他 Other

Q16:健康和健身 Health and Fitness

卫生研习会 Hygiene workshops

营养研习会 Nutrition workshops

职业指导 Career guidance

在乡村社区举办健康外展日 Organising health outreach days in rural communities

运动指导与健身 Sports coaching and fitness

急救知识研习会 First Aid workshops

其他 Other

Q17:环境 Environment

回收计划 Recycling initiatives

水箱和过滤器 Water tanks and filters

家用太阳能 Household solar

其他 Other

Q18:艺术 Arts

摄影 Photography

音乐 Music

话剧 Drama

绘画 Drawing

其他 Other

Q19:其他建议 Other ideas

选项1

Q20:请填写您可以参加志愿者活动的时间范围

选项1

:分割线

:公益经验 VOLUNTEER EXPERIENCE

Q21:描述一下你以前做志愿者的经历。（请说明你在做什么，在哪里做，做了多长时间）Describe any previous volunteering experience you have. (Please mention what you were doing, where, and for how long)

选项1

Q22:请描述您为什么想在格伦家族基金会帮助项目中做志愿者？Please describe why you want to volunteer in GFF HELPS programme?

选项1

Q23:您可以为项目带来什么技能、经验或个人特质?What skills, experience or personal attributes do you bring to the programme?

选项1

:分割线

:健康状况 HEALTH

Q24:您是否需要接受持续性治疗?如果是，请详细说明，因为这将是我们确认您是否有能力参加志愿者活动的重要依据。Do you require any ongoing medical treatment? If yes, please describe in detail as this will serve as an important basis for us to confirm your ability to participate in volunteer activities.

选项1

Q25:您是否曾接受过药物治疗或心理健康咨询?Have you ever been prescribed medication or received counselling for a mental health diagnosis?

选项1

:个人声明 DECLARATION

Q26:Do you currently have a visa issued by the Chinese immigration office?（中国公民请跳过此项 Chinese citizens please skip this item）

选项1

Q27:您是否有任何未决的起诉或曾经被判有罪?如有，请提供所有详情，包括;罪行性质、日期及最终裁决。Do you have any prosecutions pending or have you ever been convicted of a criminal offense? If YES, please provide all details including; nature of offense, dates and final ruling.

选项1

Q28:您是否需要告知我们有关纪律处分的程序，或您曾否被要求离职/参加义工活动?Do you need to inform us of disciplinary procedures or have you been asked to leave employment / volunteer activity?

选项1

Q29:本人确认所提供的资料真实无误，并已阅读及接受有关条款及细则（详情请见下方链接）。I confirm that the information supplied is true and correct, and that I have read and accept the terms and conditions. （The terms and conditions are available here: http://gffhelps.org/terms-and-conditions/）

确认 Confirm

Q30:签名 SIGNATURE

姓名（请填写具有法律效应的姓名） Legal Name

日期

格伦家族基金会（海南分会）帮助计划志愿者申请表Glenn Family Foundation (Hainan Branch) HELPS Programme Volunteer Application Form

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