• PART 1
  • PART 2
  • Review
  • Thankyou
some text

Participant must be 18+ on 19th July 2019 to be eligible to take part in the Conference as an individual. If you are under 18 at that time, please register with a group leader aged 18+.

Organisers:
University & College YMCA Department, Chinese YMCA of Hong Kong
Office of Student Affairs, Hong Kong Baptist University

Find out more -> https://sa.hkbu.edu.hk/lqc/IYCSI2019.

PART 1
Personal Particulars - 1. Group Leader/ Participant (1)
Family Name *
First Name *
Middle Name *
Please fill in N/A if not applicable.
Name by which you are commonly known *
Gender *
Date of Birth *
(dd/mm/yyyy) e.g. 01/01/1999
Age *
Country of Residence *
Nationality *
Contact Number (Home/Office) *
(Country Code/Area Code) Number, e.g. (852) 23456789
Contact Number (Mobile) *
(Country Code/Area Code) Number, e.g. (852) 23456789
Email Address *
Alternate Email Address *
Passport Number *
Passport Type *
e.g. HKSAR Passport, UK Passport, Cambodian Passport
Place of Issue *
Issue Date *
(dd/mm/yyyy) e.g. 01/01/1999
Expiry Date *
(dd/mm/yyyy) e.g. 01/01/1999
Name of Organisation/University that you belong to *
Job Title/Major *
Level of Education *
English Proficiency-Spoken *
English Proficiency-Written *
Religion (if applicable) *
Please fill in N/A if not applicable.
English Full Name of Your Emergency Contact Person *
Relationship with Your Emergency Contact Person *
Contact Number of Your Emergency Contact Person *
(Country Code/Area Code) Number, e.g. (852) 23456789
T-shirt Size *
Do you require a Letter of Invitation from the Organisers to obtain a visa? *
Do you have any Dietary Requirements or/ and Other Medical/ Special Requirements? *
If yes, please remarks *
Please fill in N/A if not applicable.
How do you first know this Programme? *
Personal Particulars - 2. Participant(2)
Family Name
First Name
Middle Name
Please fill in N/A if not applicable.
Name by which you are commonly known
Gender
Date of Birth
(dd/mm/yyyy) e.g. 01/01/1999
Age
Country of Residence
Nationality
Contact Number (Home/Office)
(Country Code/Area Code) Number, e.g. (852) 23456789
Contact Number (Mobile)
(Country Code/Area Code) Number, e.g. (852) 23456789
Email Address
Alternate Email Address
Passport Number
Passport Type
e.g. HKSAR Passport, UK Passport, Cambodian Passport
Place of Issue
Issue Date
(dd/mm/yyyy) e.g. 01/01/1999
Expiry Date
(dd/mm/yyyy) e.g. 01/01/1999
Name of Organisation/University that you belong to
Job Title/Major
Level of Education
English Proficiency - Spoken
English Proficiency - Written
Religion (if applicable)
Please fill in N/A if not applicable.
English Full Name of Your Emergency Contact Person
Relationship with Your Emergency Contact Person
Contact Number of Your Emergency Contact Person
(Country Code/Area Code) Number, e.g. (852) 23456789
T-shirt Size
Do you require a Letter of Invitation from the Organisers to obtain a visa?
Do you have any Dietary Requirements or/ and Other Medical/ Special Requirements?
If yes, please remarks:
Please fill in N/A if not applicable.
How do you first know this Programme?
Payment Method
Please select one of the methods below to settle the programme fee* *
*Please note that all payment is non-refundable. Applicants are responsible for all the transaction cost(s) incurred.