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父親或法定監護人 Father or Legal Guardian

母親或法定監護人 Mother or Legal Guardian

緊急聯絡人(父母/監護人以外之親戚或朋友) Nearest relative or friends to contact, in case of emergency, if parent or legal guardian is not accessible

兄弟姊妹 Brother(s) and Sister(s)

請列出你會說或曾經學過的語言 Indicate the foreign languages you speak and/or have studied

請勾選現在/曾經罹患的疾病 Indicate with an X if you have or have had any of the following illnesses

ASSE/WH計畫規定與同意書 ASSE/WH STUDENT PROGRAM RULES AND CONSENT AGREEMENT