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HONG KONG MODEL UNITED NATIONS CLUB
Room 812-813, Youth Square, 238 Chai Wan Road, Chai Wan, Hong Kong
Tel: (852) 3172 2232 Fax: (852) 3172 2231 E-mail: info@hkmunc.org.hk
Dear Students,
Invitation to the Hong Kong Model United Nations Conference 2012
On behalf of the Hong Kong Model United Nations Club, we sincerely invite you to join the upcoming Hong Kong Model
United Nations Conference 2012 (HKMUNC2012), which will be held in February 2012.
Established in 2005, HKMUNC aims at promoting MUN culture in the region, promoting world peace through
understanding and cooperation between cultures and arousing youth attention on global issues. In an MUN conference,
participants will act as diplomats representing a nation to debate on worldwide issues. Details of the conference are as
follows:
Date: 9 to 12 February, 2012
Venue: Y-square, Chai Wan
Registration fee per person: HKD 950 (excludes accommodation) or HKD 2,150 (includes accommodation)
Website: www.hkmunc.org.hk
Application Deadline: 23 December, 2011
This is our 8th time to hold the same conference. Over the past conferences, the participants enjoyed to be in a stimulation
of debate and discussion in the United Nations. That is because they had the opportunity to meet delegates from all over
around the globe, sit together and discuss world affairs.
We are looking forward to receiving your application. With your participation, we are definitely having a high-quality level
of discussion and debate in HKMUNC 2012.
Should you have any enquiries, please feel free to contact us at (852)-3172 2231 or email to info@hkmunc.org.hk.
Yours sincerely,
Heiki Tsang
President (Session 2011-2012)
Hong Kong Model United Nations Club
Tel: (852) 3172-2231
Fax: (852) 3172-2232
Email: info@hkmunc.org.hk
Website: www.hkmunc.org.hk
HONG KONG MODEL UNITED NATIONS CLUB
Room 812-813, Youth Square, 238 Chai Wan Road, Chai Wan, Hong Kong
Tel: (852) 3172 2231 Fax: (852) 3172 2232 E-mail: info@hkmunc.org.hk
HKMUNC 2012_Individual Delegation Application Form p.1
Hong Kong Model United Nations Conference 2012 INDIVIDUAL Delegation Application Form
__________________________________________________________________
Please read through the application guidelines before filling this form.
Use separate sheet(s) if necessary.
Delegates Information
Delegate Type: Please the appropriate box(s). □ Local (Local delegate includes Hong Kong local students and non-local students who are currently studying in HK.)
(Registration package: □ HKD 950, without accommodation or □HKD 2,150, with 3-days accommodation)
□ Non- Local (Registration package:HKD 2,150, with 3-days accommodation) *All non-local delegates have to stay in the hotel we provided.
A. Personal Particulars
Name in Passport / HKID: (English)
Given Name:
Surname:
中文全名:
Date of Birth (DD/MM/YY): Gender:
Nationality: Place of birth:
Residential Address:
E-mail Address:
Telephone no. : (residential) (mobile)
HKID No./ Passport No:
Country of issue: Valid Until
(DD/MM/YY):
University / College:
Form / Year:
HONG KONG MODEL UNITED NATIONS CLUB
Room 812-813, Youth Square, 238 Chai Wan Road, Chai Wan, Hong Kong
Tel: (852) 3172 2231 Fax: (852) 3172 2232 E-mail: info@hkmunc.org.hk
HKMUNC 2012_Individual Delegation Application Form p.2
B. Health Conditions (If any) All information provided here will be kept in the strictest confidence, and will solely be used for medical-related purposes only.
1. Do you have a history of any of the following sicknesses? (Select as appropriate)
Epilepsy □
Level of severity:
Regular medication:
Fits □
Level of severity:
Regular medication:
Blackouts □
Level of severity:
Regular medication:
Acute respiratory conditions □
Level of severity:
Regular medication:
Asthma □
Level of severity:
Regular medication:
Cardiac illnesses □
Level of severity:
Regular medication:
Food allergies □
Type(s) of food:
Level of severity:
Regular medication:
Others □
Level of severity:
Regular medication:
2. Specification of food
(e.g. Vegetarian diet or food you do not consume due to religious reason)
*Put N/A if it is not applicable
Please specify:
HONG KONG MODEL UNITED NATIONS CLUB
Room 812-813, Youth Square, 238 Chai Wan Road, Chai Wan, Hong Kong
Tel: (852) 3172 2231 Fax: (852) 3172 2232 E-mail: info@hkmunc.org.hk
HKMUNC 2012_Individual Delegation Application Form p.3
C. Contact Person during Emergency (Compulsory field)
D. Committee and Country Preference
Please rank your committee preference and select the country you want to represent
Rank Committee Country
World Health Organization (WHO)
Economic and Social Council (ECOSOC)
Social, Humanitarian and Cultural Committee (SOCHUM)
Security Council (SC)
Double delegation for World Health Organization (WHO), Economic and Social Council (ECOSOC) and Social, Humanitarian and Cultural Committee (SOCHUM)
Double Delegation + 5 single delegation observing countries for Security Council (SC)
E. Past MUN Experience
Please indicate (if any) your past participation in any MUN conference.
Date of Participation Organization
Surname
Given name
Residential Address
Telephone no.
E-mail Address
Relationship
HONG KONG MODEL UNITED NATIONS CLUB
Room 812-813, Youth Square, 238 Chai Wan Road, Chai Wan, Hong Kong
Tel: (852) 3172 2231 Fax: (852) 3172 2232 E-mail: info@hkmunc.org.hk
HKMUNC 2012_Individual Delegation Application Form p.4
F. Written Assignment
Please write an individual essay of ~ 500 words on why you would like to represent one of the
following countries in your most preferred committee as chosen above. (Please use separate sheets)
Argentina; Australia; Austria; Bangladesh; Belgium; Bolivia; Bosnia and Herzegovina;
Brazil; Burkina Faso; Canada; China; Colombia; Congo; Costa Rica; Croatia; Democratic
People's Republic of Korea; Democratic Republic of the Congo; France; Gabon; Georgia;
Germany; Ghana; Greece; India; Indonesia; Iran; Ireland; Israel; Italy; Japan; Lebanon;
Libya; Malaysia; Mexico; Netherlands; Nigeria; Pakistan; Panama; Peru; Portugal; Qatar;
Republic of Korea; Romania; Russian Federation; Rwanda; Saudi Arabia; Singapore; South
Africa; Spain; Sudan; Switzerland; Turkey; Uganda; United Arab Emirates; United Kingdom;
United Republic of Tanzania; United States of America; Viet Nam; Yemen
**For the detail country list of each committee, please refer to our official website**
To confirm your application, the following documents have to be submitted.
1.Copy of your Valid Student Identity Card
2.Written Assignment
DECLARATION
I , (Name), hereby declare that the information provided in the
application package is accurate and complete. I also understand the Hong Kong Model United
Nations Club has discretion over the selection of applicants. I authorize the Hong Kong Model
United Nations Club to handle and use my personal data /information provided for recruitment
and statistical purposes.
Privacy Policy: All information obtained will be kept in strictest confidence and used for
recruitment, assessment and statistical purposes only
For Secretariat Use Only
Successful Not successful
Screened by: Signature: Date:
Checked by: Signature: Date:
HONG KONG MODEL UNITED NATIONS CLUB
Room 812-813, Youth Square, 238 Chai Wan Road, Chai Wan, Hong Kong
Tel: (852) 3172 2231 Fax: (852) 3172 2232 E-mail: info@hkmunc.org.hk
HKMUNC 2012_Delegate Application Form p.1
Hong Kong Model United Nations Conference 2012 TEAM Delegation Application Form
__________________________________________________________________
Please read through the registration guidelines before filling this form.
Use separate sheet(s) if necessary.
Delegates Information
Delegate Type: Please the appropriate box(s). □ Local (Local delegate includes Hong Kong local students and non-local students who are currently studying in HK.)
(Registration package: □ HKD 950, without accommodation or □HKD 2,150, with 3-days accommodation)
□ Non- Local (Registration package:HKD 2,150, with 3-days accommodation) *All non-local delegates have to stay in the hotel we provided.
i. Each team consists of 2-6 delegates.
ii. In each team, at most 2 delegates can be in the same committee, while SC only accepts 5 single delegations.
Delegates in the same committee will represent the same country.
iii. Delegates in the same team do not mean that they will represent the same country in different committees.
Team Details
School / Team Name
Head Delegate Full Name
E-mail Address
Confirm E-mail
Mobile
Delegate Delegate Full Name Head Delegate Delegate 2 Delegate 3 Delegate 4 Delegate 5 Delegate 6
Faculty Advisor (if any)
Full Name in passport / ID (Eng):
Gender: Mobile no:
Email address:
HONG KONG MODEL UNITED NATIONS CLUB
Room 812-813, Youth Square, 238 Chai Wan Road, Chai Wan, Hong Kong
Tel: (852) 3172 2231 Fax: (852) 3172 2232 E-mail: info@hkmunc.org.hk
HKMUNC 2012_Delegate Application Form p.2
I. For Head Delegate A. Personal Particulars
Name in Passport / HKID: (English)
Given Name:
Surname:
中文全名:
Date of Birth (DD/MM/YY): Gender:
Nationality: Place of birth:
Residential Address:
E-mail Address:
Telephone no. : (residential) (mobile)
HKID No./ Passport No:
Country of issue: Valid Until
(DD/MM/YY):
University / College:
Form / Year:
B. Health Conditions (If any) All information provided here will be kept in the strictest confidence, and will solely be used for medical-related purposes only.
1. Do you have a history of any of the following sicknesses? (Select as appropriate)
Epilepsy □
Level of severity:
Regular medication:
Fits □
Level of severity:
Regular medication:
Blackouts □
Level of severity:
Regular medication:
Acute respiratory conditions □
Level of severity:
HONG KONG MODEL UNITED NATIONS CLUB
Room 812-813, Youth Square, 238 Chai Wan Road, Chai Wan, Hong Kong
Tel: (852) 3172 2231 Fax: (852) 3172 2232 E-mail: info@hkmunc.org.hk
HKMUNC 2012_Delegate Application Form p.3
Regular medication:
Asthma □
Level of severity:
Regular medication:
Cardiac illnesses □
Level of severity:
Regular medication:
Food allergies □
Type(s) of food:
Level of severity:
Regular medication:
Others □
Level of severity:
Regular medication:
2. Specification of food
(e.g. Vegetarian diet or food you do not consume due to religious reason)
*Put N/A if it is not applicable
Please specify:
C. Contact Person during Emergency (Compulsory field)
Surname
Given name
Residential Address
Telephone no.
E-mail Address
Relationship
HONG KONG MODEL UNITED NATIONS CLUB
Room 812-813, Youth Square, 238 Chai Wan Road, Chai Wan, Hong Kong
Tel: (852) 3172 2231 Fax: (852) 3172 2232 E-mail: info@hkmunc.org.hk
HKMUNC 2012_Delegate Application Form p.4
D. Committee and Country Preference
Please rank your committee preference and select the country you want to represent
Rank Committee Country
World Health Organization (WHO)
Economic and Social Council (ECOSOC)
Social, Humanitarian and Cultural Committee (SOCHUM)
Security Council (SC)
Double delegation for World Health Organization (WHO), Economic and Social Council (ECOSOC) and Social, Humanitarian and Cultural Committee (SOCHUM)
Double Delegation + 5 single delegation observing countries for Security Council (SC)
E. Past MUN Experience
Please indicate (if any) your past participation in any MUN conference.
Date of Participation Organization
F. Written Assignment
Please write an individual essay of ~ 500 words on why you would like to represent one of the
following countries in your most preferred committee as chosen above. (Please use separate sheets)
Argentina; Australia; Austria; Bangladesh; Belgium; Bolivia; Bosnia and Herzegovina;
Brazil; Burkina Faso; Canada; China; Colombia; Congo; Costa Rica; Croatia; Democratic
People's Republic of Korea; Democratic Republic of the Congo; France; Gabon; Georgia;
Germany; Ghana; Greece; India; Indonesia; Iran; Ireland; Israel; Italy; Japan; Lebanon;
Libya; Malaysia; Mexico; Netherlands; Nigeria; Pakistan; Panama; Peru; Portugal; Qatar;
Republic of Korea; Romania; Russian Federation; Rwanda; Saudi Arabia; Singapore; South
Africa; Spain; Sudan; Switzerland; Turkey; Uganda; United Arab Emirates; United Kingdom;
United Republic of Tanzania; United States of America; Viet Nam; Yemen
**For the detail country list of each committee, please refer to our official website**
To confirm your application, the following documents have to be submitted.
1.Copy of your Valid Student Identity Card
2.Written Assignment
HONG KONG MODEL UNITED NATIONS CLUB
Room 812-813, Youth Square, 238 Chai Wan Road, Chai Wan, Hong Kong
Tel: (852) 3172 2231 Fax: (852) 3172 2232 E-mail: info@hkmunc.org.hk
HKMUNC 2012_Delegate Application Form p.5
II. For Delegate 2 A. Personal Particulars
Name in Passport / HKID: (English)
Given Name:
Surname:
中文全名:
Date of Birth (DD/MM/YY): Gender:
Nationality: Place of birth:
Residential Address:
E-mail Address:
Telephone no. : (residential) (mobile)
HKID No./ Passport No:
Country of issue: Valid Until
(DD/MM/YY):
University / College:
Form / Year:
B. Health Conditions (If any) All information provided here will be kept in the strictest confidence, and will solely be used for medical-related purposes only.
2. Do you have a history of any of the following sicknesses? (Select as appropriate)
Epilepsy □
Level of severity:
Regular medication:
Fits □
Level of severity:
Regular medication:
Blackouts □
Level of severity:
Regular medication:
Acute respiratory conditions □
Level of severity:
HONG KONG MODEL UNITED NATIONS CLUB
Room 812-813, Youth Square, 238 Chai Wan Road, Chai Wan, Hong Kong
Tel: (852) 3172 2231 Fax: (852) 3172 2232 E-mail: info@hkmunc.org.hk
HKMUNC 2012_Delegate Application Form p.6
Regular medication:
Asthma □
Level of severity:
Regular medication:
Cardiac illnesses □
Level of severity:
Regular medication:
Food allergies □
Type(s) of food:
Level of severity:
Regular medication:
Others □
Level of severity:
Regular medication:
2. Specification of food
(e.g. Vegetarian diet or food you do not consume due to religious reason)
*Put N/A if it is not applicable
Please specify:
C. Contact Person during Emergency (Compulsory field)
Surname
Given name
Residential Address
Telephone no.
E-mail Address
Relationship
HONG KONG MODEL UNITED NATIONS CLUB
Room 812-813, Youth Square, 238 Chai Wan Road, Chai Wan, Hong Kong
Tel: (852) 3172 2231 Fax: (852) 3172 2232 E-mail: info@hkmunc.org.hk
HKMUNC 2012_Delegate Application Form p.7
D. Committee and Country Preference
Please rank your committee preference and select the country you want to represent
Rank Committee Country
World Health Organization (WHO)
Economic and Social Council (ECOSOC)
Social, Humanitarian and Cultural Committee (SOCHUM)
Security Council (SC)
Double delegation for World Health Organization (WHO), Economic and Social Council (ECOSOC) and Social, Humanitarian and Cultural Committee (SOCHUM)
Double Delegation + 5 single delegation observing countries for Security Council (SC)
E. Past MUN Experience
Please indicate (if any) your past participation in any MUN conference.
Date of Participation Organization
F. Written Assignment
Please write an individual essay of ~ 500 words on why you would like to represent one of the
following countries in your most preferred committee as chosen above. (Please use separate sheets)
Argentina; Australia; Austria; Bangladesh; Belgium; Bolivia; Bosnia and Herzegovina;
Brazil; Burkina Faso; Canada; China; Colombia; Congo; Costa Rica; Croatia; Democratic
People's Republic of Korea; Democratic Republic of the Congo; France; Gabon; Georgia;
Germany; Ghana; Greece; India; Indonesia; Iran; Ireland; Israel; Italy; Japan; Lebanon;
Libya; Malaysia; Mexico; Netherlands; Nigeria; Pakistan; Panama; Peru; Portugal; Qatar;
Republic of Korea; Romania; Russian Federation; Rwanda; Saudi Arabia; Singapore; South
Africa; Spain; Sudan; Switzerland; Turkey; Uganda; United Arab Emirates; United Kingdom;
United Republic of Tanzania; United States of America; Viet Nam; Yemen
**For the detail country list of each committee, please refer to our official website**
To confirm your application, the following documents have to be submitted.
1.Copy of your Valid Student Identity Card
2.Written Assignment
HONG KONG MODEL UNITED NATIONS CLUB
Room 812-813, Youth Square, 238 Chai Wan Road, Chai Wan, Hong Kong
Tel: (852) 3172 2231 Fax: (852) 3172 2232 E-mail: info@hkmunc.org.hk
HKMUNC 2012_Delegate Application Form p.8
III. For Delegate 3 A. Personal Particulars
Name in Passport / HKID: (English)
Given Name:
Surname:
中文全名:
Date of Birth (DD/MM/YY): Gender:
Nationality: Place of birth:
Residential Address:
E-mail Address:
Telephone no. : (residential) (mobile)
HKID No./ Passport No:
Country of issue: Valid Until
(DD/MM/YY):
University / College:
Form / Year:
B. Health Conditions (If any) All information provided here will be kept in the strictest confidence, and will solely be used for medical-related purposes only.
3. Do you have a history of any of the following sicknesses? (Select as appropriate)
Epilepsy □
Level of severity:
Regular medication:
Fits □
Level of severity:
Regular medication:
Blackouts □
Level of severity:
Regular medication:
Acute respiratory conditions □
Level of severity:
HONG KONG MODEL UNITED NATIONS CLUB
Room 812-813, Youth Square, 238 Chai Wan Road, Chai Wan, Hong Kong
Tel: (852) 3172 2231 Fax: (852) 3172 2232 E-mail: info@hkmunc.org.hk
HKMUNC 2012_Delegate Application Form p.9
Regular medication:
Asthma □
Level of severity:
Regular medication:
Cardiac illnesses □
Level of severity:
Regular medication:
Food allergies □
Type(s) of food:
Level of severity:
Regular medication:
Others □
Level of severity:
Regular medication:
2. Specification of food
(e.g. Vegetarian diet or food you do not consume due to religious reason)
*Put N/A if it is not applicable
Please specify:
C. Contact Person during Emergency (Compulsory field)
Surname
Given name
Residential Address
Telephone no.
E-mail Address
Relationship
HONG KONG MODEL UNITED NATIONS CLUB
Room 812-813, Youth Square, 238 Chai Wan Road, Chai Wan, Hong Kong
Tel: (852) 3172 2231 Fax: (852) 3172 2232 E-mail: info@hkmunc.org.hk
HKMUNC 2012_Delegate Application Form p.10
D. Committee and Country Preference
Please rank your committee preference and select the country you want to represent
Rank Committee Country
World Health Organization (WHO)
Economic and Social Council (ECOSOC)
Social, Humanitarian and Cultural Committee (SOCHUM)
Security Council (SC)
Double delegation for World Health Organization (WHO), Economic and Social Council (ECOSOC) and Social, Humanitarian and Cultural Committee (SOCHUM)
Double Delegation + 5 single delegation observing countries for Security Council (SC)
E. Past MUN Experience
Please indicate (if any) your past participation in any MUN conference.
Date of Participation Organization
F. Written Assignment
Please write an individual essay of ~ 500 words on why you would like to represent one of the
following countries in your most preferred committee as chosen above. (Please use separate sheets)
Argentina; Australia; Austria; Bangladesh; Belgium; Bolivia; Bosnia and Herzegovina;
Brazil; Burkina Faso; Canada; China; Colombia; Congo; Costa Rica; Croatia; Democratic
People's Republic of Korea; Democratic Republic of the Congo; France; Gabon; Georgia;
Germany; Ghana; Greece; India; Indonesia; Iran; Ireland; Israel; Italy; Japan; Lebanon;
Libya; Malaysia; Mexico; Netherlands; Nigeria; Pakistan; Panama; Peru; Portugal; Qatar;
Republic of Korea; Romania; Russian Federation; Rwanda; Saudi Arabia; Singapore; South
Africa; Spain; Sudan; Switzerland; Turkey; Uganda; United Arab Emirates; United Kingdom;
United Republic of Tanzania; United States of America; Viet Nam; Yemen
**For the detail country list of each committee, please refer to our official website**
To confirm your application, the following documents have to be submitted.
1.Copy of your Valid Student Identity Card
2.Written Assignment
HONG KONG MODEL UNITED NATIONS CLUB
Room 812-813, Youth Square, 238 Chai Wan Road, Chai Wan, Hong Kong
Tel: (852) 3172 2231 Fax: (852) 3172 2232 E-mail: info@hkmunc.org.hk
HKMUNC 2012_Delegate Application Form p.11
IV. For Delegate 4 A. Personal Particulars
Name in Passport / HKID: (English)
Given Name:
Surname:
中文全名:
Date of Birth (DD/MM/YY): Gender:
Nationality: Place of birth:
Residential Address:
E-mail Address:
Telephone no. : (residential) (mobile)
HKID No./ Passport No:
Country of issue: Valid Until
(DD/MM/YY):
University / College:
Form / Year:
B. Health Conditions (If any) All information provided here will be kept in the strictest confidence, and will solely be used for medical-related purposes only.
4. Do you have a history of any of the following sicknesses? (Select as appropriate)
Epilepsy □
Level of severity:
Regular medication:
Fits □
Level of severity:
Regular medication:
Blackouts □
Level of severity:
Regular medication:
Acute respiratory conditions □
Level of severity:
HONG KONG MODEL UNITED NATIONS CLUB
Room 812-813, Youth Square, 238 Chai Wan Road, Chai Wan, Hong Kong
Tel: (852) 3172 2231 Fax: (852) 3172 2232 E-mail: info@hkmunc.org.hk
HKMUNC 2012_Delegate Application Form p.12
Regular medication:
Asthma □
Level of severity:
Regular medication:
Cardiac illnesses □
Level of severity:
Regular medication:
Food allergies □
Type(s) of food:
Level of severity:
Regular medication:
Others □
Level of severity:
Regular medication:
2. Specification of food
(e.g. Vegetarian diet or food you do not consume due to religious reason)
*Put N/A if it is not applicable
Please specify:
C. Contact Person during Emergency (Compulsory field)
Surname
Given name
Residential Address
Telephone no.
E-mail Address
Relationship
HONG KONG MODEL UNITED NATIONS CLUB
Room 812-813, Youth Square, 238 Chai Wan Road, Chai Wan, Hong Kong
Tel: (852) 3172 2231 Fax: (852) 3172 2232 E-mail: info@hkmunc.org.hk
HKMUNC 2012_Delegate Application Form p.13
D. Committee and Country Preference
Please rank your committee preference and select the country you want to represent
Rank Committee Country
World Health Organization (WHO)
Economic and Social Council (ECOSOC)
Social, Humanitarian and Cultural Committee (SOCHUM)
Security Council (SC)
Double delegation for World Health Organization (WHO), Economic and Social Council (ECOSOC) and Social, Humanitarian and Cultural Committee (SOCHUM)
Double Delegation + 5 single delegation observing countries for Security Council (SC)
E. Past MUN Experience
Please indicate (if any) your past participation in any MUN conference.
Date of Participation Organization
F. Written Assignment
Please write an individual essay of ~ 500 words on why you would like to represent one of the
following countries in your most preferred committee as chosen above. (Please use separate sheets)
Argentina; Australia; Austria; Bangladesh; Belgium; Bolivia; Bosnia and Herzegovina;
Brazil; Burkina Faso; Canada; China; Colombia; Congo; Costa Rica; Croatia; Democratic
People's Republic of Korea; Democratic Republic of the Congo; France; Gabon; Georgia;
Germany; Ghana; Greece; India; Indonesia; Iran; Ireland; Israel; Italy; Japan; Lebanon;
Libya; Malaysia; Mexico; Netherlands; Nigeria; Pakistan; Panama; Peru; Portugal; Qatar;
Republic of Korea; Romania; Russian Federation; Rwanda; Saudi Arabia; Singapore; South
Africa; Spain; Sudan; Switzerland; Turkey; Uganda; United Arab Emirates; United Kingdom;
United Republic of Tanzania; United States of America; Viet Nam; Yemen
**For the detail country list of each committee, please refer to our official website**
To confirm your application, the following documents have to be submitted.
1.Copy of your Valid Student Identity Card
2.Written Assignment
HONG KONG MODEL UNITED NATIONS CLUB
Room 812-813, Youth Square, 238 Chai Wan Road, Chai Wan, Hong Kong
Tel: (852) 3172 2231 Fax: (852) 3172 2232 E-mail: info@hkmunc.org.hk
HKMUNC 2012_Delegate Application Form p.14
V. For Delegate 5 A. Personal Particulars
Name in Passport / HKID: (English)
Given Name:
Surname:
中文全名:
Date of Birth (DD/MM/YY): Gender:
Nationality: Place of birth:
Residential Address:
E-mail Address:
Telephone no. : (residential) (mobile)
HKID No./ Passport No:
Country of issue: Valid Until
(DD/MM/YY):
University / College:
Form / Year:
B. Health Conditions (If any) All information provided here will be kept in the strictest confidence, and will solely be used for medical-related purposes only.
5. Do you have a history of any of the following sicknesses? (Select as appropriate)
Epilepsy □
Level of severity:
Regular medication:
Fits □
Level of severity:
Regular medication:
Blackouts □
Level of severity:
Regular medication:
Acute respiratory conditions □
Level of severity:
HONG KONG MODEL UNITED NATIONS CLUB
Room 812-813, Youth Square, 238 Chai Wan Road, Chai Wan, Hong Kong
Tel: (852) 3172 2231 Fax: (852) 3172 2232 E-mail: info@hkmunc.org.hk
HKMUNC 2012_Delegate Application Form p.15
Regular medication:
Asthma □
Level of severity:
Regular medication:
Cardiac illnesses □
Level of severity:
Regular medication:
Food allergies □
Type(s) of food:
Level of severity:
Regular medication:
Others □
Level of severity:
Regular medication:
2. Specification of food
(e.g. Vegetarian diet or food you do not consume due to religious reason)
*Put N/A if it is not applicable
Please specify:
C. Contact Person during Emergency (Compulsory field)
Surname
Given name
Residential Address
Telephone no.
E-mail Address
Relationship
HONG KONG MODEL UNITED NATIONS CLUB
Room 812-813, Youth Square, 238 Chai Wan Road, Chai Wan, Hong Kong
Tel: (852) 3172 2231 Fax: (852) 3172 2232 E-mail: info@hkmunc.org.hk
HKMUNC 2012_Delegate Application Form p.16
D. Committee and Country Preference
Please rank your committee preference and select the country you want to represent
Rank Committee Country
World Health Organization (WHO)
Economic and Social Council (ECOSOC)
Social, Humanitarian and Cultural Committee (SOCHUM)
Security Council (SC)
Double delegation for World Health Organization (WHO), Economic and Social Council (ECOSOC) and Social, Humanitarian and Cultural Committee (SOCHUM)
Double Delegation + 5 single delegation observing countries for Security Council (SC)
E. Past MUN Experience
Please indicate (if any) your past participation in any MUN conference.
Date of Participation Organization
F. Written Assignment
Please write an individual essay of ~ 500 words on why you would like to represent one of the
following countries in your most preferred committee as chosen above. (Please use separate sheets)
Argentina; Australia; Austria; Bangladesh; Belgium; Bolivia; Bosnia and Herzegovina;
Brazil; Burkina Faso; Canada; China; Colombia; Congo; Costa Rica; Croatia; Democratic
People's Republic of Korea; Democratic Republic of the Congo; France; Gabon; Georgia;
Germany; Ghana; Greece; India; Indonesia; Iran; Ireland; Israel; Italy; Japan; Lebanon;
Libya; Malaysia; Mexico; Netherlands; Nigeria; Pakistan; Panama; Peru; Portugal; Qatar;
Republic of Korea; Romania; Russian Federation; Rwanda; Saudi Arabia; Singapore; South
Africa; Spain; Sudan; Switzerland; Turkey; Uganda; United Arab Emirates; United Kingdom;
United Republic of Tanzania; United States of America; Viet Nam; Yemen
**For the detail country list of each committee, please refer to our official website**
To confirm your application, the following documents have to be submitted.
1.Copy of your Valid Student Identity Card
2.Written Assignment
HONG KONG MODEL UNITED NATIONS CLUB
Room 812-813, Youth Square, 238 Chai Wan Road, Chai Wan, Hong Kong
Tel: (852) 3172 2231 Fax: (852) 3172 2232 E-mail: info@hkmunc.org.hk
HKMUNC 2012_Delegate Application Form p.17
V. For Delegate 6 A. Personal Particulars
Name in Passport / HKID: (English)
Given Name:
Surname:
中文全名:
Date of Birth (DD/MM/YY): Gender:
Nationality: Place of birth:
Residential Address:
E-mail Address:
Telephone no. : (residential) (mobile)
HKID No./ Passport No:
Country of issue: Valid Until
(DD/MM/YY):
University / College:
Form / Year:
B. Health Conditions (If any) All information provided here will be kept in the strictest confidence, and will solely be used for medical-related purposes only.
6. Do you have a history of any of the following sicknesses? (Select as appropriate)
Epilepsy □
Level of severity:
Regular medication:
Fits □
Level of severity:
Regular medication:
Blackouts □
Level of severity:
Regular medication:
Acute respiratory conditions □
Level of severity:
HONG KONG MODEL UNITED NATIONS CLUB
Room 812-813, Youth Square, 238 Chai Wan Road, Chai Wan, Hong Kong
Tel: (852) 3172 2231 Fax: (852) 3172 2232 E-mail: info@hkmunc.org.hk
HKMUNC 2012_Delegate Application Form p.18
Regular medication:
Asthma □
Level of severity:
Regular medication:
Cardiac illnesses □
Level of severity:
Regular medication:
Food allergies □
Type(s) of food:
Level of severity:
Regular medication:
Others □
Level of severity:
Regular medication:
2. Specification of food
(e.g. Vegetarian diet or food you do not consume due to religious reason)
*Put N/A if it is not applicable
Please specify:
C. Contact Person during Emergency (Compulsory field)
Surname
Given name
Residential Address
Telephone no.
E-mail Address
Relationship
HONG KONG MODEL UNITED NATIONS CLUB
Room 812-813, Youth Square, 238 Chai Wan Road, Chai Wan, Hong Kong
Tel: (852) 3172 2231 Fax: (852) 3172 2232 E-mail: info@hkmunc.org.hk
HKMUNC 2012_Delegate Application Form p.19
D. Committee and Country Preference
Please rank your committee preference and select the country you want to represent
Rank Committee Country
World Health Organization (WHO)
Economic and Social Council (ECOSOC)
Social, Humanitarian and Cultural Committee (SOCHUM)
Security Council (SC)
Double delegation for World Health Organization (WHO), Economic and Social Council (ECOSOC) and Social, Humanitarian and Cultural Committee (SOCHUM)
Double Delegation + 5 single delegation observing countries for Security Council (SC)
E. Past MUN Experience
Please indicate (if any) your past participation in any MUN conference.
Date of Participation Organization
F. Written Assignment
Please write an individual essay of ~ 500 words on why you would like to represent one of the
following countries in your most preferred committee as chosen above. (Please use separate sheets)
Argentina; Australia; Austria; Bangladesh; Belgium; Bolivia; Bosnia and Herzegovina;
Brazil; Burkina Faso; Canada; China; Colombia; Congo; Costa Rica; Croatia; Democratic
People's Republic of Korea; Democratic Republic of the Congo; France; Gabon; Georgia;
Germany; Ghana; Greece; India; Indonesia; Iran; Ireland; Israel; Italy; Japan; Lebanon;
Libya; Malaysia; Mexico; Netherlands; Nigeria; Pakistan; Panama; Peru; Portugal; Qatar;
Republic of Korea; Romania; Russian Federation; Rwanda; Saudi Arabia; Singapore; South
Africa; Spain; Sudan; Switzerland; Turkey; Uganda; United Arab Emirates; United Kingdom;
United Republic of Tanzania; United States of America; Viet Nam; Yemen
**For the detail country list of each committee, please refer to our official website**
To confirm your application, the following documents have to be submitted.
1.Copy of your Valid Student Identity Card
2.Written Assignment
HONG KONG MODEL UNITED NATIONS CLUB
Room 812-813, Youth Square, 238 Chai Wan Road, Chai Wan, Hong Kong
Tel: (852) 3172 2231 Fax: (852) 3172 2232 E-mail: info@hkmunc.org.hk
HKMUNC 2012_Delegate Application Form p.20
DECLARATION
I, (Name), the head delegate,
on behalf of (Team Name), hereby declare that the
information of mine and my fellow teammates provided in the application package is accurate
and complete. We also understand the Hong Kong Model United Nations Club has discretion
over the selection of applicants. We authorize the Hong Kong Model United Nations Club to
handle and use our personal data /information provided for recruitment and statistical
purposes.
Signature (by head delegate): Date:
Privacy Policy: All information obtained will be kept in strictest confidence and used for
recruitment, assessment and statistical purposes only
For Secretariat Use Only
Successful Not successful
Screened by: Signature: Date:
Checked by: Signature: Date:
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