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[接上页] 日期................................................ 致香港教育统筹局常任秘书长: (2003年第3号第26条) 1.现经校务委员会批准,本人申请将 ........................................................... 先生/女士/小姐注册为本学院教师,有关该人的详情列于下文。 2.详情─ (a)姓名(英文) ............................................................................................. (b)姓名(中文) ............................................................................................. (c)别名 ....................................................................................................... (d)性别 ....................................................................................................... (e)出生日期 ............................................................................................... (f)出生地点 ............................................................................................... (g)肄业的院校名称及日期─ 学校或大学 由 年/月 至 年/月 ............................................. ............................................. ( ) ............................................. ............................................. ( ) ............................................. ............................................. ( ) (h)学历资格 ............................................................................................... (证书、文凭、学位) ............................................................................................................................................................................................ ................................................................................................................ ................................................................................................................ (i)离开学校、学院或大学后曾从事教学以外的职业细节 ................................................................................................................................... ................................................................................................................ ................................................................................................................ ................................................................................................................ (j)所有教学经验细节─ 学校 (注明年/月) 任教班级 任教科目 (k)任何曾发表的作品或原创研究的细节 ............................................................................................................................................................... 3.将任教科目 .................................................................................................. 4.拟付薪金 ...................................................................................................... 5.全职或兼任 ................................................................................................... (如属兼任,注明时数) ................................................................................6.有关该教师的品格,可向以下人士查询,此等人士知悉/不知悉在此表格上填写的各项陈述:─ (a)姓名 ............................................... 职业 ............................................. 地址 .......................................................................................................(b)姓名 ............................................... 职业 ............................................. 地址 .......................................................................................................7.本人附交该教师的─ (a)签名照片3张 (b)健康检查证明书 (c)学历证书或其他有关学历资格的证据。 照片 身分证号码 .............................. (签署) ....................................... 校长 注:此表格须填写一式两份。 |