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OS application form st sem

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									THE UNIVERSITY OF HONG KONG HKU FAMILY INSTITUTE Application for Admission as Occasional Student 2008/2009
(for taking individual modules under the Master of Social Sciences in Marriage and Family Therapy)
The personal data provided in this form will be used for processing your application for enrolment on the relevant modules, by the administrative and academic departments concerned. If you wish to access or correct your personal data after submission of this form, please contact HKU Family Institute. An attendance certificate will only be issued (by HKU Family Institute) to students who have attended at least 80% of the teaching sessions of their chosen modules and completed all the required assignments/examinations. Section A 1. PERSONAL INFORMATION Name of Applicant:
Mr./ Ms./ Mrs./ Dr.

Surname Correspondence Address:

Given name

Chinese name

Contact No.:

(Home) (Mobile)

(Office) (Fax)

E-mail Address: 2. PRESENT OCCUPATION Name & Address of Organization:

Position Held: 3. QUALIFICATIONS

Starting Date:

(Attach officially certified transcripts, with a complete record of the courses attended and examination results, for ALL tertiary level studies. Transcripts and diplomas which are not in English should be accompanied by a certified translation in English)

4.

COURSE ENROLLMENT Please register me as an Occasional Student for the following module(s) for 1st semester 2008-2009: Course Code(s) and Title(s): (1) (2) (3) Total Number of Module(s) #:

# An occasional student is allowed to take a maximum of 3 courses in a semester.

Completed application form should be sent to:

HKU Family Institute 5/F Tsan Yuk Hospital, 30 Hospital Road Sai Ying Pun, Hong Kong

The composition fee for each module is HK$10,000. You will be informed of the payment procedures once your application for the relevant module(s) has/have been approved. Fees paid are not refundable.

For enquiries, please contact HKU Family Institute at 2859-5300 or via e-mail mftinfo@hku.hk.

IMPORTANT NOTES: The module(s) taken by an Occasional Student is (are) non-credit bearing. Occasional Students would not be regarded as Regular Students of the University and have no access to the University’s facilities for regular students but are covered by the Public Liability (Insurance) Policy. A certificate may be issued by the Institute to an Occasional Student attending at least 80% of the teaching sessions and completing of all the required assignments/examinations but no official transcript from the University will be provided.

Signature:

Date:

Section B (For Official Use Only) From: To: Your application for the following module(s) has/has not (have/have not) been approved in 1st semester of 2008-2009. Director, HKU Family Institute The University of Hong Kong

Remarks:

Signature:

Date:


								
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