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3 Youth Mobility Scheme of the United Kingdom 英国「青年流动计划」 Registration Form for the Certificate of Sponsorship (2019 Main Round) 「赞助者证明」登记表格(2019 年首轮) Note 注意: (i) Please read the "Guidance Notes on Applying a Visa under the Youth Mobility Scheme of the United Kingdom" carefully before completing this form.

填写此表格前请细阅《申请 英国「青年流动计划」签证须知》 . (ii) Registrations shall be submitted within the registration period. Registrations submitted before or after the registration period will NOT be processed. 所有登记须在登记期内提 交.在登记期之前或之后提交的登记将不获受理. (iii) Please complete this form in BLOCK LETTERS using black or blue pen. 请用黑色或蓝 色笔以正楷填写本表格. (iv) The ORIGNAL completed registration form should be submitted with the following supporting documents of the registrant: (i) a photocopy of his/her Hong Kong Identity Card;

and (ii) a photocopy of his/her valid HKSAR passport showing the holder's personal particulars and passport number. 填妥的登记表格正本须连同以下登记人的文件递交: (i)香港身份证影印本乙份;

及(ii)有效的香港特别行政区护照 (备有持有人个人资料及 护照号码)影印本乙份. (v) Please specify "2019 Main Round CoS Registration" on the envelope cover, and the registrant's correspondence address on the back of the envelope. 信封面请注明「2019 年 首轮『赞助者证明』登记」 ,并在信封底写上登记人的通讯地址. Part I: Personal Particulars (All parts must be completed) 第一部分:个人资料(所有资料必须填写) Surname in English 姓(英文) : (as shown on Hong Kong Identity Card 如香港身份证所示) Given Name in full in English 名(英文) : (as shown on Hong Kong Identity Card 如香港身份证所示) Name in Chinese (if applicable) 姓名(中文) (如适用) : (as shown on Hong Kong Identity Card 如香港身份证所示) Sex 性别 : Male (男) Female (女) (please tick as appropriate 在适当方格填上「?」号) Date of Birth 出生日期 : (dd)/ (mm)/ (yyyy) For official use only Registration Number: Date of receipt: (Post chop/date chop) Registration Completed 登记已完成 Page

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3 Part I: Personal Particulars (Continued) 第一部分:个人资料(续) Hong Kong Identity Card Number 香港身份证号码 : ( ) HKSAR Passport Number 香港特别行政区护照号码 : Contact Telephone Number in Hong Kong 香港联络电话号码 : Mobile phone 手提电话) Home 住宅 / Office 办事处) Email address in full 电邮地址(全址) (Please provide one email address only 请只提供一个电邮地址) Part II: Declaration 第二部分:声明 Registrants must read and sign in person the declaration below. 申请人必须阅读并亲自签署以 下声明: I have read the "Guidance Notes on Applying a Visa under the Youth Mobility Scheme of the United Kingdom". I understand and agree to the arrangement in relation to the registration such as vetting, balloting, etc. I hereby undertake and warrant that I shall comply with all requirements set out in the above-mentioned Guidance Notes in making this registration, and declare the following: 本人已阅读《申请英国「青年流动计划」签证须知》 .本人明白及同意与登记有关如审 核、抽签程序等的安排.本人承诺及保证本人遵从在上述《须知》内列出的所有规定以 作此登记,并谨此声明: (a) the information provided on this registration form and the representations thereon and supporting documents submitted by me are true, complete and accurate. I undertake to report any change of information provided in this registration and submit relevant information to the Labour Department as soon as possible for consideration by the Labour Department regarding my eligibility for the Certificate of Sponsorship. 这份登记表内填报的资料及本人的陈述和提交的证明文件均属真实、完整和准确. 本人承诺若登记资料有任何更改,必定会尽快向劳工处申报并提供有关资料,以供 劳工处考虑本人申领赞助者证明的登记资格. Registration Completed 登记已完成 Page