A. I Love Taiwan Mission 2011 (June28 - July14) B. The Youth Forum of the National Fate of Taiwan (July15-17) Application FormDate29 – 04 - 2011Name PassportVuite LaldampuiaChinese CharactersGenderFM Photo Date of Birth 2 2 2 2 nd nd nd nd July July July July, , 19 19 19 1979 79 79 79 Passport Number H H H 93538 93538 93538 935384 4 43 3 3 3 Church Presbyterian church of India Presbyterian church of India Presbyterian church of India Presbyterian church of India Occupation Self Employed Self Employed Self Employed Self Employed School / MajorBachelor of Arts Bachelor of Arts Bachelor of Arts Bachelor of Arts Address Aizawl, Mizoram. India Aizawl, Mizoram. India Aizawl, Mizoram. India Aizawl, Mizoram. India Tel/ Fax (T… +91 +91 +91 +91 98： 98： 98： 98：23：0034 23：0034 23：0034 23：0034 (F… Email Emergency contact Name: Sang Sang Sang Sangthanga thanga thanga thangaPhone number+91 9862578300Relation: FatherFatherFatherFatherLanguage Ability Taiwanese Mandarin English OthersSpeak Read & Write Listen I wish to I wish to I wish to I wish to apply apply apply apply forforforfor (please select one or both, which you would like to participate… A. I Love Taiwan Mission 2011 (June28 □ July14… B. The Youth Forum of the National Fate of Taiwan (July15□17… Have you ever participated in ILT? Have you ever participated in ILT? Have you ever participated in ILT? Have you ever participated in ILT? If yes, please note which year and attend which church in Taiwan. No Yes, , church Special Skills Musi c Drama Ar t ComputerStor y□Te lling Ins truments Field ofinterest Kids teac hing leading Teen age rs Community service Environmental concerns BriefIntroduction of yourselfSpe cial Nee d Vege tar ian Aller gy Othe rs Parent Endorse Applicant Sign Local Church Endorse Please fill it out and send back to your denomination contact person.
