Online Nomination

請於填寫網上提名表格前先閱畢參選人及提名人須知

Please read through the Nomination Guide before completing the online Nomination Form.

第一部分 PART I :
A. 提名人資料 PERSONAL PARTICULARS OF NOMINATOR

只須一位提名人填寫表格。其他提名人只需在D部份遞交推薦信而無需填寫提名表格。
Only one nominator needs to fill out the Nomination Form. Other nominators are only required to submit a reference letter in support of the candidate in Section D.

( 請註明 Please specify: )
性別 Sex:
英文姓名 English Name:
中文姓名 Chinese Name:
日間電話 Daytime Tel No.:
手提電話 Mobile Phone No.:
傳真號碼 Fax No.:
電郵地址 Email Address:
確認電郵地址 Confirm Email Address:
通訊地址 Correspondence Address:
機構名稱 Name of Organisation:
職位 Position:
與參選人關係 Relationship with Candidate:
與參選人認識年期 Length of Acquaintance:
如何得悉本大獎? How did you learn about the Award? (可選擇多於一個 Can select more than one)
( 請註明 Please specify: )
B. 參選人服務記錄 SERVICE RECORD OF CANDIDATE
1. 社區及公共服務年資 Years of Community and Public Service:
2. 服務崗位 Service Position:
( 請註明 Please specify: )
3. 服務持續性 Service Continuity:
4. 每年總服務人次* Annual Number of People Served*:
5. 管理的團隊人數 Size of Service Team/Organisation Managed by Candidate:
6. 傳媒報導 Media Coverage (請附上相關證明文件 Please upload supporting document(s)):
(文件上限 Maximum: 5MB)

*服務人次以每個計劃的參加人數作計算,假如該受惠者參與10個活動,將作10人次計算。
*Annual Number of People Served is counted per programme. If a service recipient joined 10 programmes, it will be counted as 10 attendances.

C. 提名原因 REASONS FOR NOMINATION

請以不多於500字闡述參選人的服務事跡。(可附上照片、剪報及其他相關資料,如以影像短片,請以網絡連結,如YouTube 連結遞交)。
Please elaborate the service accomplishments and record of the candidat in no more than 500 words (Attachments with photos, news clipping and related information are welcome. Please provide us with an internet link(such as YouTube) if you would like to submit a video).

(文件上限 Maximum: 5MB)

請詳述提名原因,包括:
Please clearly explain the reasons of nomination, and include:

  • 參選人須具備充分的服務紀錄,反映是項大獎的核心價值和信念,當中包括對香港的承擔,以及願意為香港作出貢獻等;
    Detailed record of candidate's community and public service, exemplifying the core values of service, which include dedication and commitment to Hong Kong;
  • 參選人須持續地投入服務香港社會,並產生具體的影響;
    Detailed track record of consistent and impactful service in the community;
  • 參選人須以實證說明對社會的裨益,以及如何回應社會的需要;
    Evidence of measurable impact in meeting a community need;
  • 參選人須擁有領導才能及良好品格,值得青年學效。
    Support indicating candidate's potential leadership skills and competencies, including ability to be a role model to others.

聲明 Declaration:

本人謹此聲明提名表格及附件所提供的資料,在本人所知範疇內,真確無訛。
I declare that all the information given above in the Nomination Form and relevant attachments are true and correct.
本人同意主辦機構及評審團作的決定為最後裁決。
I also agree to abide by the final decision made by the Organiser and Selection Panel.

第二部分 PART II : *請填寫此部分的所有資料 Please fill in ALL information in this part
D. 參選人資料 PERSONAL PARTICULARS OF CANDIDATE
( 請註明 Please specify: )
性別 Sex:
英文姓名 English Name:
中文姓名 Chinese Name:
出生年份 Year of Birth:
日間電話 Daytime Tel No.:
手提電話 Mobile Phone No.:
傳真號碼 Fax No.:
電郵地址 Email Address:
確認電郵地址 Confirm Email Address:
通訊地址 Correspondence Address:
工作機構名稱 Name of Organisation:
職位 Position:
擔任公職/專業學會/非牟利機構職務 Major Positions and Appointments in Public Services/Professional Associations/NGOs

請由近至遠的時間排列,列出最多5項職務。 Please list 5 positions at most in descending chronological order.

1.
機構名稱 Name of Organisation
 
職位 Position
年份 Year
機構名稱 Name of Organisation
 
年份 Year
職位 Position
請以一個檔案上載其他提名人的推薦信 (如適用)
If appropriate, please upload reference letters from other nominators in ONE file
(文件上限 Maximum: 3MB)
如何得悉本大獎? How do you know the Award? (可選擇多於一個 Can select more than one)
( 請註明 Please specify: )
過往你曾否被提名參選香港青年服務大獎?
Have you ever been nominated for The Hong Kong Youth Service Award previously?
E. 報名原因 PERSONAL STATEMENT

請以不多於500字詳述你的服務心志和行動如何為香港社會帶來具體轉變或裨益,以及甚麼原因促使你抱有上述願意為香港服務的心志。
Please use no more than 500 words telling us how your service makes an impact on Hong Kong and what had led you on your journey.

如有其他相關文件,請以一個檔案在此上載 Please upload any other supporting documents here in ONE file
(文件上限 Maximum: 3MB)
聲明 Declaration
  • 每位參選人只須填寫一份提名表格。
    Only one Nomination Form will be accepted for the same candidate.
  • 所有提交的文件資料及物件,恕不退還。
    Attached copies of the relevant documents and supporting documents will not be returned.
  • 在填寫提名表格及附件時,如有任何遺漏或所有遞交資料不全或不實,均可能影響參選者的參選資格。
    Please ensure that all parts of the Nomination Form and the supporting documents are completed accurately. Failure to do so may affect the assessment work of the Organiser.
*本人 / 本會上述的安排。
*I agree/ do not agree to all information as stated above.
本人願意被提名,並謹此聲明提名表格及附件所提供的資料真確無訛。
I agree with the nomination and declare that all the information given above is true and correct.
本人同意主辦機構及評審團作的決定為最後裁決。
I also agree to the final decision made by the Organiser and Selection Panel.
個人資料收集聲明 Personal Information Collection Statement
本人已得悉並同意收集個人資料聲明
I have read and agree to the Personal Information Collection Statement .
*本人 / 青年協會向我提供青協及有關單位的資訊
*I agree/ do not agree to receive any news and information related to the HKFYG and its service units.
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