Apr 2021 (Phase IV)
「青年委員自薦計劃」申請表
Member Self-recommendation Scheme for Youth
Application Form
在填寫本申請表前,請先細閱須知事項。Please read the Points-to-Note carefully before you complete this form.
個人資料 PERSONAL PARTICULARS
稱謂
Title
先生Mr 女士Ms 小姐Miss 太太Mrs 博士Dr(Degree)
醫生Dr(Medical) 其他(請註明)Others (please specify)
相片
(可選擇提供)
Photo
(optional)
中文姓名
Name in Chinese
(
如香港身份證
/
護照所示
as shown on Hong Kong Identity Card/Passport)
中文姓名電碼
Chinese Name in Code
(
如香港身份證所示
as shown on Hong Kong Identity Card)
英文姓名
Name in English
(姓氏 Surname) (名字 Given Names)
(
如香港身份證
/
護照所示
as shown on Hong Kong Identity Card/Passport)
別名(如適用)
Other Name (if applicable)
性別
Gender
M F
出生日期 Date of Birth
/ /
(
DD) / (
MM) / (
YYYY)
香港身份證號碼
Hong Kong Identity
Card No.
( )
護照號碼
Passport No.
簽發地點
Place of Issue
(
只適用於未能提供香港身份證號碼的申請人
only for applicants who cannot provide Hong Kong Identity Card No.)
是否香港永久性居民
Are you a Hong Kong Permanent Resident?
Yes No
國籍
Nationality
聯絡電話號碼
Contact Tel. No.
電郵地址
Email Address
通訊地址 Correspondence Address
能講或能寫的語言/方言(可選擇多於一項)
Languages/Dialects that you can understand
(may choose more than one item)
中文 Chinese 英文 English 廣東話 Cantonese 普通話 Putonghua
其他(請註明)Others (please specify)
教育及資格 EDUCATION AND QUALIFICATIONS
教育程度
Educational Attainment
小學 Primary 中學 Secondary 大專 Post-Secondary 大學 University
大學學位以上 Post-graduate or above
現正/曾就讀的學校(可選擇填寫)School(s) Attending/Attended (optional)
學校 School 課程及級別 Programme and Class
From
(MM/YYYY)
To
(MM/YYYY)
獲取資格(如適用) Qualifications Attained (if applicable)
申請編號
Application No.
(本欄不必填寫 for official use only)
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Apr 2021 (Phase IV)
職業/專業 OCCUPATION/PROFESSION
請在下列各項選擇一項最能代表你的職業/專業:
Please choose one of the following which best describes your occupation/profession:
會計 Accountancy
漁農業 Agriculture and fisheries
建築、都市規劃及測量 Architectural, planning and surveying
藝術及文化 Arts and culture
銀行及金融服務 Banking and financial services
商業 Business
飲食 Catering
教育 Education
工程 Engineering
酒店及旅遊 Hotel and tourism
人力資源 Human resources
進出口 Import and export
資訊科技 Information technology
保險業 Insurance
法律 Legal
製造業 Manufacturing industry
市場推廣 Marketing
醫療
生服務 Medical and health services
地產及建造業 Real estate and construction
宗教 Religious
社會企業及社會創新 Social enterprise and social
innovation
社會福利 Social welfare
體育 Sports
學生 Student
高等教育 Tertiary education
航運交通及物流 Transport and logistics
批發及零售 Wholesale and retail
其他(請註明)Others (please specify):
____________________________________________
現時職位(如適用) Current Employment (if applicable)
公司/機構 Company/Organisation
職銜 Post Title
業務性質 Nature of Business
過去工作經驗(如適用) Past Working Experience (if applicable)
公司/機構 Company/Organisation
職銜 Post Title
業務性質 Nature of Business
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Apr 2021 (Phase IV)
申請編號
Application No.
(本欄不必填寫 for official use only)
興趣/專業知識 INTEREST/EXPERTISE
請註明你對下列那方面有興趣關注或有專業知識 (可選擇多於一項):
Please indicate your interest/expertise in any of the following fields (may choose more than one item):
漁農業 Agriculture and fisheries
上訴委員會 Appeal boards
藝術、演藝事業及文化 Arts, performing arts and culture
兒童事務 Children matters
教育 Education
長者事務 Elderly matters
環境問題 Environmental matters
金融(包括會計、銀行、保險及證券Finance (including
accountancy, banking, insurance and securities)
性別課題 Gender matters
酒店及旅遊 Hotel and tourism
勞工事務 Labour matters
土地及房屋 Land and housing
治安 Law and order
法律問題 Legal matters
牌照事務 Licensing
製造業 Manufacturing industry
在囚人士福利 Offenders’ welfare
公眾健康及
Public health and hygiene
科學及科技 Science and technology
社會創新 Social innovation
社會福利 Social welfare
體育及康樂 Sports and recreation
電訊及廣播 Telecommunication and broadcasting
貿易 Trade
航運交通及物流 Transport and logistics
信託基金 Trust funds
青年事務 Youth matters
其他(請註明)Others (please specify):
____________________________________________
社會服務(如適用) COMMUNITY SERVICE (if applicable)
委員會 / 團體 / 活動名稱
Name of Board / Committee / Organisation / Activity
職位
Capacity
From
(MM/YYYY)
To
(MM/YYYY)
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Apr 2021 (Phase IV)
申請的委員會 COMMITTEE(S) APPLIED FOR
請選擇你想加入的政府委員會。你只能申請加入最多兩個政府委員會,請在適當方格內填上「1」及「2」來表明你的選擇
及其優次(1 為首選,2 次選)。
Please indicate which committee(s) you wish to join. You may apply for joining at most two committees. Please prioritise your
preference in the boxes below by filling in “1” (first choice) and “2” (second choice).
保育歷史建築諮詢委員會
就保育歷史建築基金的運作,包括活化歷史建築伙伴計劃、歷史
建築維修資助計劃、公眾參與項目及主題研究資助計劃,向政府
提供意見。
Advisory Committee on Built Heritage Conservation
To advise the Government on the operation of the Built Heritage Conservation
Fund, including the Revitalising Historic Buildings Through Partnership Scheme,
the Financial Assistance for Maintenance Scheme on Built Heritage, and funding
schemes for public engagement projects and thematic research.
廉政公署社區關係市民諮詢委員會
向廉政專員建議如何爭取公眾支持打擊貪污及如何教育公眾認識
貪污的害處,聽取及要求廉政公署社區關係處報告為達致上述目
標而進行的工作,並監察公眾對廉署工作的反應以及對貪污所持
的一般態度。
Citizens Advisory Committee on Community Relations of
the Independent Commission Against Corruption
To advise the Commissioner of the Independent Commission Against Corruption
measures to be taken to foster public support in combating corruption and to
educate the public against the evils of corruption; receive and call for reports on
related action taken by the Community Relations Department of the Commission;
and monitor community response to the Commission’s work and public attitudes
towards corruption in general.
鄉郊保育諮詢委員會
審視鄉郊保育資助計劃的申請、監督核准項目的實施情況,及就
資助計劃的政策事務及鄉郊保育辦公室建議的鄉郊保育及活化工
程提供意見。
Advisory Committee on Countryside Conservation
To examine the applications under the Countryside Conservation Funding
Scheme (“CCFS”), oversee the progress of the approved projects and advise on
the policy matters of the CCFS and the conservation and revitalisation works
proposals of the Countryside Conservation Office.
降低食物中鹽和糖委員會
就減低香港巿民鹽和糖的攝入量,制定政策方向及統籌相關工
作,以及制定減低香港食物中鹽和糖含量的工作計劃,監督計劃
的推行及作出檢討。
Committee on Reduction of Salt and Sugar in Food
To steer the direction and coordinate the work of reducing salt and sugar intake by
the local population; to formulate and oversee the implementation and evaluation
of the Action Plans for Salt and Sugar Reduction in Food in Hong Kong.
創科生活基金評審委員會
評審創科生活基金〈「基金」〉的申請項目、決定項目應否獲得
撥款資助及資助金額、監察獲撥款項目的進度,以及就基金的運
作提供意見等。
Assessment Panel of the Innovation and Technology Fund
for Better Living
To assess applications under the Innovation and Technology Fund for Better
Living (“FBL”), decide whether they should be approved and the amount of fund
grant, monitor the progress of approved applications and advise on matters
relating to the operation of the FBL, etc.
能源諮詢委員會
就能源政策,包括有關能源供求、節約與效益的政策事宜,及其
他由政府轉介給委員會考慮的相關事宜,向政府提供意見。
Energy Advisory Committee
To advise the Government on energy policy, including policy matters concerning
energy supply and demand, energy conservation and efficiency, and other related
matters referred to it by the Government.
方便營商諮詢委員會
就制訂和推行利便香港營商的計劃及措施,向財政司司長提供意
見,在致力確保條例遵規及保障公眾利益的同時,亦令規管環境
更具競爭力。
Business Facilitation Advisory Committee
To advise the Financial Secretary on the development and implementation of
programmes and measures that aim to facilitate business in Hong Kong and entail
effort to ensure compliance with government regulations for safeguarding public
interest while sustaining a competitive regulatory environment.
家庭議會
提倡重視家庭觀念和推廣家庭核心價值,作為促進社會和諧的原
動力;並就制定支援和強化家庭政策及策略,向政府提供意見。
Family Council
To advocate for cherishing the family and to promote family core values as a main
driver for social harmony as well as to advise the Government on the formulation
of policies and strategies for supporting and strengthening the family.
中文界面諮詢委員會
就在本港制訂及推廣共通中文界面的事宜,包括向國際標準化組
織提交本地中文電腦用字、協調各界人士有關本地中文電腦用字
的需求等,向政府提供意見。
Chinese Language Interface Advisory Committee
To advise the Government on various aspects regarding the development and
promotion of a common Chinese language interface in Hong Kong, including
submission of local characters for Chinese computer systems to the International
Organization for Standardization, co-ordination with different sectors on the need
for local characters for Chinese computer systems, etc.
香港海運港口局
為港口及海運服務業訂定長遠發展方向、推動業界人力資源發
展,及制定推廣策略和措施,以提升香港的國際海運中心地位。
Hong Kong Maritime and Port Board
To set the direction for the long-term development of Hong Kong's port and
maritime services, foster the development of maritime manpower, and devise
promotion strategies and initiatives to enhance Hong Kong's status as an
international maritime centre.
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Apr 2021 (Phase IV)
申請編號
Application No.
(本欄不必填寫 for official use only)
社會福利界資訊科技聯合委員會
協調及監察福利界的資訊科技發展,並推動資訊科技在福利界的
應用,以提升管治及改善福利服務的提供
Joint Committee on Information Technology for the Social
Welfare Sector
To coordinate and oversee the IT development in the welfare sector, and to
promote use of IT for better management and delivery of welfare services in the
sector.
兒童發展基金督導委員會
就兒童發展基金〈「基金」〉計劃事宜如推動友師的參與、目標
儲蓄計劃和配對捐款等提供意見,並督導及監察基金的落實工
作、宣傳推廣、顧問研究工作以及審議其他相關事宜。
Steering Committee on the Child Development Fund
To provide inputs to Child Development Fund (“CDF”) project matters such as
mentorship programme, targeted savings and matching contribution, oversee and
monitor the implementation, promotion and consultancy of the CDF as well as
consider other related matters.
優質教育基金推廣及宣傳專責委員會
為優質教育基金制定推廣及宣傳策略,推廣基金計劃的意念、做
法及經驗,並提升基金在推動香港優質教育方面的形象。
Quality Education Fund Dissemination and Promotion
Sub-committee
To formulate dissemination and promotion strategies for the Quality Education
Fund (“QEF”) to promote the ideas, practices and experiences of QEF projects
and to enhance the image of QEF in promoting quality education in Hong Kong.
推廣職業專才教育和資歷架構督導委員會
監督整體的職業專才〈「職專」〉教育推廣策略、加強統籌,以
及推動更緊密的業界夥伴合作,並向政府提供意見,以透過更協
調的方法進一步促進香港職專教育及資歷架構的發展。
Steering Committee on Promotion of Vocational and
Professional Education and Training and Qualifications
Framework
To oversee the overall Vocational and Professional Education and Training
(“VPET”) promotion strategy, strengthen coordination, and foster closer industry
partnership as well as to provide advice to the Government on the promotion of
VPET and Qualifications Framework through a more coordinated approach.
中小型企業委員會
就影響本港中小型企業發展的事宜向行政長官提出意見,並建議
所需採取的措施,藉此支援及促進中小型企業的發展。
Small and Medium Enterprises Committee
To advise the Chief Executive on issues affecting the development of small and
medium enterprises in Hong Kong and to suggest measures to support and
facilitate their development and growth.
如欲查閱以上15個委員會的詳細職權範圍及其他資訊,
可瀏覽民政事務局的網頁。
You may visit the website of the Home Affairs Bureau for
the detailed terms of reference and other information of the
above 15 committees.
請選擇()以下其中一個方式以中文或英文闡述你為何適合獲委任為所選的政府委員會的成員(如你對社會服務的熱
誠、對有關政策範疇的認識等)。
Please choose (“”) one of the following ways to explain, in either Chinese or English, your suitability of being appointed to be a
member of the selected committee(s) (such as your enthusiasm in serving the community, knowledge of the policy areas concerned,
etc.).
(a) 提交一段不長於 3 鐘的影片(以 mp4 格式錄製)錄音(以 m4a 格式錄製)
To provide a video (in mp4 format) or an audio clip (in m4a format) of no longer than 3 minutes
你可於雲端儲存平台
例如 Google 雲端硬碟, Dropbox, Microsoft OneDrive分享你的影片或錄音並在以
下空格提供相關連結
You may share the video or audio clip via cloud storage platform (e.g., Google Drive, Dropbox, Microsoft
OneDrive) and provide the relevant URL link below:
如欲以其他方式提交影片或錄音,請參閱民政事務局網頁有關的提交要求。
Please refer to the website of the Home Affairs Bureau for relevant requirements for submitting the video or audio
clip via other means.
OR
(b) 在以下空格以不多 600 字作闡述
To write no more than 600 words in the following field:
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Apr 2021 (Phase IV)
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Apr 2021 (Phase IV)
申請編號
Application No.
(本
欄不必填寫 for official use only)
聲明 DECLARATION
本人提交此申請表並謹此聲明,在此申請表上填報的資料,就本人所知,均屬真確及最新的資料。本人明白並同
意,本人所提供的個人資料可作須知事項第3點的用途。
By submission of this form, I declare that the information provided in this application form is accurate and up-to-date to the
best of my knowledge. I agree and understand that the personal data I have provided may be used for the purposes listed in
item 3 of the Points-to-Note.
日期 Date
須知事項 POINTS-TO-NOTE
1. 請填妥申請表各項,並提供正確資料
Please ensure that all parts in the form are completed and the information is accurate.
2. 如未能按
申請表的指示填報所有所需資料,申請表可能不獲受理。
Your application may not be considered if you fail to provide all information requested along the instructions in this form
.
3. 在本申請
表內所提供的個人資料,將用於委任工作以及其他與委任有關的事宜上。如有需要,有關資料可能會送
交獲授權處理有關資料的政府政策局/部門及其他組織或機構,用以進行與政府委任有關的事宜。
The personal data provided in this form will be used for appointment and other appointment-related purposes. It may be
provided to government bureaux/departments and other organisations or agencies authorised to process the information fo
r
pu
rposes relating to appointment by the Government as may be necessary.
4. 提交此申請表後,如欲更改或查詢個人資料,可向民政事務局提出:
香港添馬添美道2
政府總部西翼12樓民政事務
青年委員自薦計劃
(電話:3509 7621 / 電郵地址:selfrecommendation@hab.gov.hk
For correction of or access to personal data after submission of this form, please approach the Home Affairs Bureau:
Member Self-recommendation Scheme for Youth,
Home Affairs Bureau, 12/F West Wing, Central Government Offices,
2 Tim Mei Avenue, Tamar, Hong Kong.
(Tel: 3509 7621 / Email Address: selfrecommendation@hab.gov.hk)
5. 請於民政事務局的網頁 (http://www.hab.gov.hk/) 參閱遞交申請資料的方法。
Please refer to the website of the Home Affairs Bureau (http://www.hab.gov.hk/) for details related to submission of th
e
application materials.
下列只用作統計用途,申請人可選擇是否填寫。
For statistical purposes only, applicants are welcome to provide the following information.
請問你從何途徑得知第四期「青年委員自薦計劃」的招募可選擇多於一項
From which channel(s) you are brought to the attention of the recruitment of the Member Self-recommendation Scheme for Youth
Phase IV (may choose more than one item)?
報章 Newspapers
電視
Television
電台 Radio
流動應用程式 Mobile Applications
社交媒體(請註明)Social Media (please specify):
____________________________________________
學校/機構/非牟利團體(請註明)
Schools/Organisations/NGOs (please specify):
____________________________________________
巴士 Bus
港鐵 MTR
海報 Poster
電子郵件 Email
親友 Relatives/Friends
政府網站 Government Websites
其他(請註明)Others (please specify):
____________________________________________