1971-HKRS30-16-30_Part04 — Page 20

See NOTE 2.

參閱附註一

See NOTE X.

三

See NOTE 4.

關

西

48

(m) Other relevant information

3. The following persons who are fare not aware of the statements

拥向下列雨龀游购人查詢△核

made on this form may be referred to as regards my character:

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

(甲)姓名(光生/夫人/小姐)

Address

地址

Occupation

職業

(b) Name (Mr./Mrs./Miss)

(乙)姓名「先生/夫人/小姐)

Address

地址

Occupation

|

1 affix above a signed full face photograph of myself and atlech 四本八日在上面貼上糨署之正面半身脂片 張現竑随

two signed copies of such photograph to this application.

同本申蹐爾附在舉之间機照片甫

3. I attach

五

(a)

附

a medical certificate as to my healib; and

(b) my educational certificates.

ศ The contents of this application are true and complete to the

*

best of my knowledge and belief.

(Signed)

申請人籃署

NOTE : To be completed only if the applicant is a married, divorced

歲日d

or widowed woman.

口

NOTE 2: If the applicant has been convicted of a criminal offence 附註二 申湖人狗目被判犯有刑案罪而致有退其 affecting his character, or has been refused previously approval

49

to be a manager, registration as a manager or teacher, or a

注册嚚機或敢員

+

permit to teach as a permitted teacher, or has had his approval

to be a manager withdrawn or bia registration as a manager or

teacher or his permit to teach as a permitted teacher cancelled,

the full circumstances of such matter must be disclosed.

+

NOTE 3: Two referees are required. They must be persons of standing. 附三

e.p. members of the Executive or Legislative Council, Justices

of the Peace, barristers-at-law, solicitors, ministers of religion,

NOTE 4:

附註四

chartered or incorporated accountants, persons on the list of 會計師,特别陪客名翠内恋人士檢定 special jurors, registered teachers, doctars or dentists, etc., and

must have known the applicant well for at least three years. 少三年

If educational certificates are not available at the date of the

application, paragraph 5(5) may be deleted. However the

applicant may be required to produce any such certificates at

a later date for inspection,

WARNING. 警告

Alleation is drawn la the provisions of the Education Ordinance 1971

and particularly to--

(a) Section 46–– [甲]第四十方款

PA

"The Director may refuse to register an applicant as a 「教育划在下述情形得拒您將申缾人註册蹒

teacher if it appears to him that the applicant-

+

()) in making or in connexion with any application—

於申蘭或齿及申请

(i) for approval to be a manager;

認可爲校董時;或