1971-HKRS30-16-30_Part04 — Page 19

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See NOTE 1,

46

Address for correspondence jioni 通讯地址

(0) Places of education:

47

Signed full face 在此貼上與

photograph of

Telephone Number „......renad

applicant to be 正面半身服少 affixed here.

電喆髀數

Date

日期

The Director of Education,

Education Department,

Hong Kong.

香港效咨

德者:

1 forward the following particulars of myself and request you

to register me as a teacher.

་

Particulars-

(a) Name (Mr./Mrs./Miss):

(in English)

tin Chinese)

(*)

(b) Aliases

流

(c) Marital slalus:

Married/Single

Name of schools

學校

Date of entry

and

政

(month and year)

universities 太學名雕

(爛何年何月)

()

(1)

(10)

Date of leaving

離機日期

(month and year)

C墉関何年何月)

Educational qualifications (degrees, diplomas, certificates)

(*) Details of occupations, other thân teaching, since completion of

education

(D) Details of all teaching experience:

婚姻狀況:

未婚

()()Maiden nare

(i) Husband's name reliedenbakken com 或來姓名

(e) Residential address

住址

( Identity Card Number

(g) Date of birth

左生日期

(4) Place of birth

咖啡

School

學校名稱

Date of

Date of

Classes

commence- ment

任職日期 (month and year) 【攜團同年

leaving

離職日期 fmonth

and year)

(欄明何年 何月]

taught 所教 项

Subjects

taught

所数 节目