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Name(Last/Family, First/Given, Middle):
Occupation:
Monthly Income (HK Dollars):
Name of Employer, address and contact number (separated by line):
Residence (Present) Address:
Email Address:
Home Phone in HK:
Mobile Phone:
Gender:
Marital Status:
Date of Birth (Ex: January 1, 1980):
Religion:
Father's Name:
Occupation:
Mother's Maiden Name:
Occupation:
Educational Background (School, From year to year, Degree) (Elementary to Tertiary, separated by a line):
Desired Program:
Other Desired Program (Optional, please specify):
Which local organization are you affiliated?
"I hereby certify that all the written information about myself herein is correct. I further agree that I have understood my rights and responsibilities expected of me as a student at SRIA/SRTMC. I promise to be committed to finishing my program in good faith."
Date of Application (Month/Day/Year):

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