澳門王琦書院首期意向學員初步登記表
Initial Registration Form for Macau Wang Qi Academy

1.本問卷僅用於初步登記意向學員，學員資格尚待書院篩選確定，資格確認後會通知學員。
This questionnaire is intended for the initial registration of prospective students at Macau Wang Qi Academy.Student eligibility is subject to assessment and confirmation by the academy, and successful applicants will be notified accordingly once their eligibility has been verified.
2.王琦書院為全公益性质、高層次中醫藥人才的培養平臺，學員無需繳納任何學費。但如有交通食宿費用，則需自理。
Wang Qi Academy is a non-profit platform for training high-level TCM professionals. Students do not need to pay any tuition fees. However, they are responsible for their own travel, accommodation, and meal expenses.
*
1.
姓名
Full Name
*
2.
工作單位
Institution
*
3.
職稱、職務（範例:教授，中醫藥學院院長)
Professional title & position（Example: Professor, Dean of Faculty of Chinese Medicine)
*
4.
教育經歷 （範例：
2020.9–2023.6 澳門科技大學 中醫藥學院 中醫學博士；
2017.9–2020.6 廣中醫 第一臨床醫學院 中西醫結合碩士；
2013.9–2017.6 南中醫 中醫學院 中醫學學士）
Educational experience （Example：
2020.9–2023.6 MUST, Faculty of Chinese Medicine,  Doctor of Chinese Medicine；
2017.9–2020.6 GZUCM,  School of 1st Clinical Medicine, Master of Integrated Medicine；
2013.9–2017.6 NJUCM,  School of Chinese Medicine,  Bachelor of Chinese Medicine ）

*
5.
工作經歷 (範例：
2023年7月至今，南京中醫藥大學附屬醫院，教授、主任醫師；
2020年9月至2023年6月，廣州中醫藥大學第一附屬醫院，副主任醫師)
Work experience（Example：
2023.07–Present  Affiliated Hospital of Nanjing University of Chinese Medicine,  Professor & Chief Physician; 
2020.09–2023.06   First Affiliated Hospital of Guangzhou University of Chinese Medicine, Associate Physician)
*
6.
其他個人簡介（包括但不限於個人專長、研究方向、獲獎、證書或其他補充說明）
Other personal profiles（including your professional expertise, research interests, qualifications, awards or other relevant information）
*
7.
聯繫地址（示例：中國 廣東省 廣州市 越秀區 中山二路 XX 號）
Contact Address（No. XX, Zhongshan 2nd Road, Yuexiu District, Guangzhou City, Guangdong Province, P.R. China）
*
8.
聯繫電話（國際區號-電話，示例：853-********）
Phone number (International dialing code - telephone number, example: 853-********)
*
9.
聯繫電郵
Email
*
10.

您是否能參加2026年3月27日書院揭牌儀式及首期培訓？Are you able to attend the academy's unveiling ceremony and first training session on March 27, 2026?

11.
如您想補充說明其他情況，請填寫
If you would like to add any other information, please fill it out here.
问卷星提供技术支持
举报