Dragon 100 2019 Application Form

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Before you start this application, please read the following notes carefully:

1. This form cannot be saved.

2. Unless specified, please fill in the form in ENGLISH.

3. You will have to upload certain documents before submitting the form, you are strongly advised to read through the application and get hold of these documents before you start the application; these documents includes (but not limited to) Nomination Form (get template here), coloured headshot, documentary evidence (e.g. graduation certicicate, student card, transcript, etc).

4. If you cannot see the contents in the form, do not click refresh, just swich between tabs in the form and give it time to load.

5. The Dragon Foundation is not responsible for any loss and damage of data.

Enquiry: info@dragonfoundation.net
1. Personal Particulars
1.
English Name (As on your travel document) *
Surname:     First Name:
2.
Chinese Name*
3.
Birthday*
4.
Gender*
5.
Nationality*
6.
Chinese Ethnicity*
7.
Country / Region of Residence *
8.
Coloured headshot (Your photo will be published in the delegation booklet so make sure it shows your full frontal face and looks good. Min. photo size: W400 px x H600 px; Format: 300 dpi in JPEG or TIF. Please name the file as [Surname]_[First Name]-photo.jpg)*
2. Correspondence
9.
Primary Email Address*
10.
Additional Email Address*
11.
Mobile No.*
Emergency Contact (in country of residence)
12.
Name of Contact Person*
13.
Relationship with you*
14.
Tel. No.*
15.
Email Address*
3. Language Proficiency
16.
English*
17.
Putonghua*
18.
Other Languages (if applicable, please specify)
19.
Level of proficiency of the above language
20.
Other Languages (if applicable, please specify)
21.
Level of proficiency of the above language
4. Nomination


To complete the application, a valid nomination from a person representing an educational institution, business corporation, non-profit organisation, professional body or registered community group must be submitted together with this application.

You may use our Nomination Form or submit a recommendation letter that is written on an official organisational / institutional / company letterhead paper together with the nominator’s business card. In this case, the letter can be addressed to Mr Gary Tang, Secretry-General of The Dragon Foundation.

Download Nomination From
22.
Upload your nomination form*
23.
Salutation of Nominator*
24.
Name of Nominator*
25.
Organisation*
26.
Position*
27.
Correspondence Address*
28.
Country / Region of Nominating Organisation*
29.
Tel. No.*
30.
Email Address*
31.
Relationship to Nominee*
32.
Nominee's Years of Residence in Represented Country*
33.
Note: The applicant's amount of experience in the country / region of the nominating organisation will be a part of the selection criteria and will be used as his/her represented country / region. If the applicant wishes to represent another country / region, please select YES below. A valid reason must be given if YES is selected. The Dragon Foundation reserves the right to final decisions.*
34.
Represented Country / Region
If you choose No, please select the country of your nominating organisation*
35.
Nominee's Years of Residence in Country of nominating organisation
If you choose No, please select the country of your nominating organisation*
36.
Reason for representing another country / region:
If you choose no, please type "Nil".*
5. Occupation

Your occupation will be published in the delegation booklet if you become a delegate.
If you have multiple jobs / positions, please only input the one that you would like others to know.
37.
Company / Organisation / Institute*
38.
Job Title*
39.
How would you categorise the type of your job?*
40.
You may upload your name card here (optional)
6. Education Background

Your highest educational level attained / to be attained will be published in the delegation booklet if you become a delegate.
Please only tell us about your post-secondary education.

6.1 Highest education level attained / to be attained
41.
What is your highest educational level attained / to be attained?
*
42.
If you choose others, please specify:
43.
Name of Institution
44.
If your school is not on the list, please enter below:
45.
Year (From):     Year (To): *
46.
Name of Degree (e.g. Bachelor of Business Administration in Accounting)*
6.2 Second Highest educational level attained / to be attained (Optional)
47.
What is your second highest educational level attained / to be attained?
48.
If you choose others, please specify:
49.
Name of Institution
50.
If your school is not on the list, please enter below:
51.
Year (From):     Year (To): 
52.
Name of Degree (e.g. Bachelor of Business Administration in Accounting)
53.
You have to provide documents that can prove your educational level. These documents can be a graduation certificate, transcript, student card, etc. If you have more than one supporting document, compress them into one file to upload.*
7. Attainments
54.
Please input up to 10 of your most remarkable qualifications, scholarships or awards.
1. Year Awarded:
Name of Qualification / Scholarship / Award:
Awarding Authority:
2. Year Awarded:
Name of Qualification / Scholarship / Award:
Awarding Authority:
3. Year Awarded:
Name of Qualification / Scholarship / Award:
Awarding Authority:
4. Year Awarded:
Name of Qualification / Scholarship / Award:
Awarding Authority:
5. Year Awarded:
Name of Qualification / Scholarship / Award:
Awarding Authority:
6. Year Awarded:
Name of Qualification / Scholarship / Award:
Awarding Authority:
7. Year Awarded:
Name of Qualification / Scholarship / Award:
Awarding Authority:
8. Year Awarded:
Name of Qualification / Scholarship / Award:
Awarding Authority:
9. Year Awarded:
Name of Qualification / Scholarship / Award:
Awarding Authority:
10. Year Awarded:
Name of Qualification / Scholarship / Award:
Awarding Authority:
55.
You have to provide documents that can prove your attainment(s). These documents can be a certificate, letter, etc. If you have more than one supporting document, compress them into one file to upload.
8. Community Service Experience
56.
Please input up to 10 of your most remarkable voluntary positions held / events organised.
Notes:
1. Only input voluntary services.
2. Do not specify every single event for the same position held (e.g. If you were a president of an organisation, simply input President of that organisation, instead of inputting each of the events in your tenure). In this case, input "N/A" in the "Event" field.
1. Date (From):     Date (To):
Organisation:
Event:
Position Held: 
2. Date (From): Date (To):
Organisation:
Event:
Position Held:
3. Date (From): Date (To):
Organisation:
Event:
Position Held:
4. Date (From): Date (To):
Organisation:
Event:
Position Held:
5. Date (From): Date (To):
Organisation:
Event:
Position Held:
6. Date (From): Date (To):
Organisation:
Event:
Position Held:
7. Date (From): Date (To):
Organisation:
Event:
Position Held:
8. Date (From): Date (To):
Organisation:
Event:
Position Held:
9. Date (From): Date (To):
Organisation:
Event:
Position Held:
10. Date (From): Date (To):
Organisation:
Event:
Position Held:
9. Short Essay

Please write a short essay in English on the following question. (word limit: 400 words)

Your answer will be used as a part of the selection process and will be printed in the delegation booklet if you become a delegate.
57.
Some say buzzwords like sustainability and innovation are overused - we hear them chanted everyday from mission statements, corporate agendas to even personal statements but how these concepts are being visualised are sometimes in question. Generally, in what area(s) do you think we see an imminent need of turning ideas into real action or have already observed disruption in place? Which area(s), do you think, deserve(s) more focus or even the highest priority?* (400 words most)
10. Questionnaire
58.
Where did you learn about the Programme?* 【Multiple】
11. Declaration

Privacy Policy Statement
The Dragon Foundation respects personal data and is committed to fully implementing and complying with the data protection principles and all relevant provisions of the Personal Data (Privacy) Ordinance in Hong Kong. All the personal data and information provided by applicants in this application form will be used solely for purposes relevant to the Foundation's programme. All data will be kept strictly confidential and access to them is restricted to authorised personnel only. Applicants with enquiries about their personal data, including requests for access or correction purposes, should contact the Foundation's Secretariat at info@dragonfoundation.net.
59.
By submitting this application form, I confirm that:

1. I am eligible to apply for the "Dragon 100 2019", and have submitted the documents stipulated;

2. I declare that the details given in this form are correct and I understand that any misrepresentation of facts would lead to disqualification of the application;

3. I give my consent to The Dragon Foundation Secretariat to carry out necessary reference checks and investigations with the nominator or relevant school(s), company(s) and organisation(s) for the purpose of assessing this application. I also give my consent to the school(s), company(s) and organisation(s) concerned for my personal data to be released to the Secretariat;

4. I am physically and mentally fit for the programme;

5. I will commit and contribute my best throughout the programme.

*
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