二零零九年十一月xx日限阅文件-ElderAcademy.docVIP

1 計劃基本資料 Project Information ……………………………………………………........... 長者學苑發展Application Form (Other Application) 1.1 機構名稱 (中文)： Name of Organisation (Eng): 1.2 計劃名稱 (中文)： (Eng): 1.3 開始及結束日期： Commencement and Completion Date: (DD/MM/YY – DD/MM/YY) 1.4 申請總額：Amount requested: $ 1.5 目標對象 Target Group(s): 1.6 計劃類別 Project Nature: 講座 Seminar 展覽 Exhibition 研究 Research 其他 (請說明:___________________) Others (Please specify:____________) 1.7 計劃簡介 Project Summary 請以不多於三百字扼要概述計劃內容、目的及如何鼓勵長者學習促進長幼共融and inter-generational harmony. Contents beyond the specified word limit will not be considered. 描述/Description 2 計劃詳情Project Details ……………………………………………………........... 2.1 計劃整體預期成效及具體目的 Overall Projected Outcomes and Specific Objectives of the Project (A) 整體預期成效 Overall Projected Outcomes (B) 具體目的 Specific Objectives (i) (ii) (iii) . . . 2.2 協作夥伴資料 Information on Collaborators 請列出與主要協作夥伴之建議合作方案。只提供場地或協助宣傳不在此列。 Please provide details on the proposed collaboration. Entities which purely provide support through the provision of venue or assistance in promotion will not be considered as key collaborators. 合作機構名稱 Name of the Collaborator(s) 請簡述有關機構在計劃的合作性質 Please briefly describe the nature of collaboration 聯絡人 Contact Person(s) 姓名 Name 職位 Position 電話號碼 Telephone Number 傳真號碼 Fax Number 電郵地址 Email Address 2.3 活動內容及推行時間表 Implementation Timetable and Content of Activities 同一系列及性質的活動只需填寫一次 Only one entry required for the same series or nature of activities 推行活動 性質/名稱 Activity Nature/Name 項目目標 Programme Objectives 內容 Content 推行時段 Implementation Period (MM/YY) 2.4 請詳述計劃的表現指標 Please Describe the Outcome Indicators of the Project 計劃整體成效的表現指標 Overall Outcome Indicators 請具體說明在計劃完結時預期達致的整體成效及目的（須與2.1項相符）之表現指標 Please specify the indicators of the overall projected outcomes and specific objectives (to align with 2.1) of the project.