Nomination Form for Outstanding Ethnic Minority Student Award Scheme 2026
請填妥本表格，並於二零二六年三月六日 (下午五時正) 或之前 以下列其中一種方式遞交。Please complete and submit this form by a method below on or before 6 March2026 (5 p.m.)電郵Email: po5.link@hkcn.org.hk ; 或 OR 傳真Fax: 3563 6677 ; 或 OR 郵遞 by post : LINK Centre(葵涌葵涌道1019-1025號昌年大廈地下 Shop B-E, G/F, Cheong Nin Building, 1019-1025Kwai Chung Road, Kwai Chung, N.T., HK)
A. 組別School Category （請選擇 Please select as appropriate）
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小學 小一至小三 Primary 1-3
小學 小四至小六 Primary4-6
中學 中一至中三 Secondary 1-3
中學 中四至中六 Secondary 4-6
B. 學校資料School Information
學校名稱：School Name:
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聯絡老師名稱：Name of the Teacher in charge:
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聯絡老師電話：Telephone of the Teacher in charge:
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聯絡老師電郵地址：Email Address of the Teacher in charge:
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C. 學生資料Student’s Information
英文姓名（請以正楷填寫）：Name in English (in BLOCK LETTERS):
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First Name
Last Name
中文姓名（如適用）：Name in Chinese (if applicable):
First Name
Last Name
就讀班級：Class Attending:
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性別：Sex:
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香港身分證／護照號碼：HKID Card / Passport No.:（首4位數字或字母）(First 4 digits)
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出生日期：Date of Birth:
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Day
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Month
Year
Date
種族：Ethnicity:
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居住地區：Living District:
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D. 提名內容Content for Nomination
Content for Nomination請參考提名指引中的評分準則，以中文或英文簡述此學生在過往一年於各項的表現。Please briefly describe in English or Chinese the student’s performances in various aspects in the past year. Kindly refer to the assessment criteria in the ‘Nomination Guidelines’ for scoring proportions foreach School Category.
(D1)Academic Performances 學業成績表現 (30%) Please list the most recent examination result. 請填寫最近一次考試成績。
Rows
Position in Form
排名/人數(全級)
Marks
成績/總分
Grade
等級
Month/Year
(Student Report)
月份/年份
(成績表)
Award
Received
(if applicable)
曾獲獎項(如適用)
Remarks
(Academic curriculum 課程)
(if applicable) (如適用)
Chinese
Language 中國語文
English
Language
英國語文
Mathematics
數學
Other Subjects (Please specify : ____________ ) 其他學科,請註明 :
Please provide a copy of documentary proof for each item. 請上載最近年度的成績表副本。
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D2)Student Conduct校內操行 (5%) Please list the most recent conduct performance in the student report. 請填寫最近一次成績表上的品行評估。
Rows
Month/Year
(Student Report)
月份/年份 (成績表)
Grade
等級
Title of Award Received (if applicable)曾獲獎項或稱許 (如適用)
List here
Please provide a copy of documentary proof for each item. 請上載最近年度的成績表副本。
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D3)Academic Awards/Scholarships 學術獎項/獎學金 (10%) Please list awards received in the past 3 years. Maximum 5 items. 請填寫最多五項於最近三年所獲得的學術獎項或者獎學金。
Rows
Month/ Year of Award月份/年份
Title
of Award Received
獎項/獎學金名稱
Award
Title
獎項銜頭
Award
Organiser/ Scholarship
主辦機構
1
2
3
4
5
Please provide a copy of documentary proof for each item. 請上載相關證明文件。
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D4)Non-Academic Awards/Scholarships 非學術獎項/獎學金 (10%) Please list non-academic related awards, such as debate, speech, music, sports, dance,etc. received in the past 3 years. Maximum 5 items. 請填寫最多五項於最近三年所獲得的非學術獎項或者獎學金，例如辯論、朗誦、音樂、體育、舞蹈等。
Rows
Month/ Year of Award月份/年份
Title
of Award Received
獎項/獎學金名稱
Award
Title
獎項銜頭
Award
Organiser/ Scholarship
主辦機構
1
2
3
4
5
Please provide a copy of documentary proof for each item. 請上載相關證明文件。
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D5)School Activities and Leadership Ability 校內的活動參與及領導才能 (20%) Please list a maximum of 10 school activities, positions, and any awards or qualifications received at school in the past 3 years. 請填寫最多十項於最近三年在校內所參與的課外活動、職位及其獲得獎項或資格。
Rows
Month/ Year月份/年份
Name of Activity服務/活動
Position
職位
Duties/Activities
Participated
職責/活動參與內容
Award/Qualification
Received (if applicable)
曾獲獎項/資格(如適用)
1
2
3
4
5
6
7
8
9
10
Please provide a copy of documentary proof for each item. 請上載相關證明文件。
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D6)Extracurricular Activities and Community Service Experiences 校外的活動參與及社會服務經驗 (20%) Please list a maximum of 10 extracurricular activities, qualifications received, and social services provided to the organizations outside of the school in the past3 years. The service recipients must be outside of the school. 請填寫最多十項於最近三年在校外所參與的課外活動、資格及所參加的社會服務，服務對象必須為校外人士。e.g. Red Cross, NGO, etc. 例如紅十字會、社福機構等。
Rows
Month/ Year月份/年份
Name of Activity服務/活動
Position
職位
Activities
Participated/ Nature of Service活動參與/服務內容
Total
No. of Service Hours (if applicable)
合共服務時數(如適用)
Qualifications
Received
(if applicable)
曾獲資格(如適用)
1
2
3
4
5
6
7
8
9
10
Please provide a copy of documentary proof for each item. 請上載相關證明文件。
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D7)Reasons for the Nomination 提名原因 (5%) 請簡述提名此學生角逐傑出非華裔學生獎勵計劃的原因，例如學生如何在遇到挑戰或挫折時，積極克服困難，表現出堅毅的精神，並不限於學術表現。Briefly describe why you would like to nominate this student for the award, e.g., how the student has been persistent and positive in overcoming challenges despite of difficulties etc. It is not limited to school academic performances.
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E)聲明 Declaration
本人謹此聲明並確認以下內容：I hereby declare and confirm the below content. 就本人所知及相信，在本表格內所提供的各項資料，均屬正確和真實。The information given in this nomination form is true and correct to the best of my knowledge and belief. 本人確認，如上述學生成為入圍者及/或得獎者，他/她將出席以下活動。如學生缺席活動，LINK Centre有權取消其參加資格。I confirm, shall the nominated student become a finalist and/or winner, he/she can attend the required activities as below. LINK Centre has the right to disqualify the student if he/she is absent from the required activities. *所有入圍者必須出席All finalists are required to attend for assessment #所有得獎者必須出席All winners are required to attend 本人授權܇LINK Centre使用在計劃期間所拍攝的照片/短片，為記錄及作宣傳之用。I authorize LINK Centre to use photographs/videos taken during the Award Scheme for programme record and promotional use. 本人知悉及同意LINKCentre有權於合理情況及遵照計劃目標的精神下，修訂上述所有規則或資料，並擁有所有最終決定權。Upholding the objective of the Award Scheme and under reasonable conditions, I acknowledge and agree that LINK Centre has the right to revise the rules and information of the Scheme and reserves the rights to all final decisions.
聯絡老師簽署： Signature of the Teacher in charge:
Date
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Day
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Month
Year
Date
Submit Nomination
Submit Nomination
Should be Empty: