LCS285( Nov2018)LCS285( Nov2018)LeisureandCulturalServicesDepartmentForOfficialUseOnly/ValidUntil口/Certificate:口 /FirstAidCertificate:口/CoachCard:ApplicationforRecruitmentasaPart-timeInstructors/Leaders/CampCounsellors(I)PersonalParticulars #口 口Name (inEnglish) (inChinese) Sex#MaleFemaleIdentityDocumentNo. Age DateofBirthDayMonthYearAddress(inEnglish)(inChinese)Tel.No.(Home)(Office)(MobilePhone)(EmailAddress)(II)#Education#口Primaryorbelow口 口Secondary Post-secondaryorabove#AreyouapermanentresidentofHongKongSpecialAdministrativeRegion?# Yes#Coursescanbeconductedin#口口 口Tel.No.(Home)(Office)(MobilePhone)(EmailAddress)(II)#Education#口Primaryorbelow口 口Secondary Post-secondaryorabove#AreyouapermanentresidentofHongKongSpecialAdministrativeRegion?# Yes#Coursescanbeconductedin#口口 口CantonesePutonghuaEnglish口口No口 Other,pleasespecifyTypeofSport/ActivityApplyingfor:(UseONEapplicationformforeachsport/activity)(III)PreviousExperience/YearofServiceasinstructorforthesport/activityapplyingfor:Certificate/DocumentIssuingOrganisationDateofIssuedd/mm/yyyyValidUntildd/mm/yyyy(IV) RelevantQualificationsTimeDay7 - 12 (7am-12nn)12-6 (12nn-6pm)6-11 (6pm-11pm)MondaytoFridaySaturdaySunday&PublicHolidays(V) . . ( .) /TimeAvailablef0rService(Morethanonealternativeisallowed):Pleaseticktheappropriatebox(es).# /Pleaseticktheappropriatebox(es)Pleaseturnover(1) ( ) (1-3) 3 (1 )Districtspreferred(Threealternativesareallowed):Pleaseindicateinorderofpriority(1-3)infollowingbox(es)(1-mostpreferable).HongKongIsland:Central&WesternEasternSouthern帝K國WanChaiKowloon:KowloonCityKwunTongShamShuiPoWongTaiSinYauTsimMongNewTerritoriesEast:NorthSaiKungShaTinTaiPoNewTerritoriesWest:IslandsKwaiTsingTsuenWanTuenMunYuenLong⑵ /Venuespreferred(Morethanonechoiceisallowed):Pleaseticktheappropriatebox(es).口 □ 口□LadyMacLehoseHolidayVillageTsoKungTamOutdoorRecreationCentreSaiKungOutdoorRecreationCentre LeiYueMunParkHolidayCampsandWaterSportsCentres:\JockeyClubWongShekWaterSportsCentre 口TaiMeiTukWaterSpo.Centre 口ChongHingWaterSportsCentre□ 口口TuenMunRecreation&SportsCentre St.Stephen’sBeachWaterSportsCentre StanleyMainBeachWaterSportsCentreDeclarationIconfirmthatalltheaboveparticularsarecorrect.Ifthereisanychangeofthedata,IshallinformtheSportsOfficialDevelopmentUnit(SOD)oftheLeisureandCulturalServicesDepartment(LCSD)toupdatetherecord.Iherebyconsenttothedisclosureofmynameinthepublicitymaterialsintheformofsportsprogrammesinordertofacilitatethegeneralpublic’senrolmenttothoseprogrammes.( )Forthepurposeofintegrity(includingcriminalrecords)checkingbeforeemploymentisofferedtomebytheLCSD,Iamrequiredtoprovidetherequestedinformationandtheauthorisationformasstipulatedinthe‘SupplementaryInformationforApplicationFormforEmploymentwiththeGovernmentoftheHongKongSpecialAdministrativeRegion’andreturnthecompletedformtotherecruitingoffice.DateSignatureofApplicantNoteTOC\o"1-5"\h\z/ /65 65 / /LCSDmaintainsaDataBaseforrecruitedpart-timeinstructors/leaders/campcounsellorsandwouldofferemploymenttothemonaneedbasistoassistinconductingrecreationandsportsprogrammes.TheagelimitforserviceasNon-civilServiceContractstaffintheDepartmentis65.Applicantsaged65orabovewillgenerallynotbeconsideredforthepostsofpart-timeinstructors/leaders/campcounsellors./ / ( 1 3)Pleasereturnthecompletedformandbringalongtheoriginalofinstructor/leader/campcounsellorcertificate(s)totheSODoftheLCSDorproducethephotocopyofthecertificate(s)bymail.(Address:3/F,LeisureandCulturalServicesHeadquarters,1-3PaiTauStreet,ShaTin,NewTerritories)/ /Theinformationprovidedwillbeusedforapplicationforrecruitmentaspart-timeinstructors/leaders/campcounsellorsoftheLCSDandforfuturecontactpurposes.ApartfromstaffdulyauthorisedbytheDepartment,noonewillbegivenaccesstoyourpersonaldata.Forcorrectionoforaccesstopersonaldatacontainedinthisapplication,pleasecontactourstaffoftheSODUnitoftheLCSD.Theprovisionofthepersonaldataforprocessingthisapplicationisvoluntary.Youmaybeaskedtoprovideadditionalinformationtohelpusmeetyourrequest.TheDepartmentmaynotbeabletoprocessyourapplicationifyoudonotprovidesufficientinformation.(http://www.hongkongpost.hk/tc/postage_calculator/index.html)Tosubmittheapplicationformbypost,pleasemakesurethatallmailitemsbearsufficientpostage.ThisDepartmentwillnotacceptanyunderpaidmailitemsandsuchitemswillbehandledbytheHongkongPost.Forcalculationofpostage,pleaserefertotheHongkongPost’swebsite(http://www.hongkongpost.hk/en/postage_calculator/index.html).Enquiries: 26018874 Pleas