THE UNIVERSITY OF HONG KONG Certificate in Chinese Language Application for Admission
The completed form should be returned to the Academic Services Enquiry Office, Rm UG-05, Knowles Building, The University of Hong Kong, Pokfulam Road, Hong Kong together with 1. a photocopy of your HKID card/passport/birth certificate; if you are applying on grounds of “mature age”, an officially certified copy* of the document; 2. the officially certified copies* of academic transcripts and examination results; 3. the proof of payment of the application fee HK$300. (Please refer to the “Payment of Application Fee” sheet.) An acknowledgement card is issued on receipt of the application.
recent passport-sized photograph
1.
COURSE OF STUDY SOUGHT#
Stream: Putonghua Cantonese Year: First Second
2.
PERSONAL INFORMATION Mr./Mrs./Ms./Miss _________________________________________ Full name in block letters, surname first
Name in Chinese, if any
Sex _____ Age ______ Marital status ________ Date of birth (dd/mm/yyyy) _____________________ HKID Card/Passport number _______________________Country of birth ___________________ Nationality _______________________ Country of permanent residence ______________________ Do you require a student visa / student entry permit to study in HK?
#
Yes
No
University number (if admitted to HKU previously) ____________________________________________ Address of correspondence ___________________________________________________________ _________________________________________________________________________________ Address in Hong Kong (if any or if different from above) ________________________________________ _________________________________________________________________________________ HK telephone number (Home) ______________________ (Office) __________________________ Email address _____________________________________________________________________
* Officially certified copies of documents Copies of your original documents [transcripts, examination results, or HKID card/passport/birth certificates (in the case of mature applicants only)] must be certified by the issuing authority concerned, or a school principal or a notary public. The name, status, and position of the person certifying the copies must be clearly stated. In the case of documents supplied by universities and colleges, they should either bear the seals of the institutions and be signed by an appropriate official or be sent to the University directly by the institutions concerned. Alternatively, if you are in Hong Kong, you may come to our Academic Services Enquiry Office during office hours (Mon-Fri: 9am-5:30pm, Sat:9am-12:30pm) bringing with you the original documents and one set of photocopies for our verification. Please DO NOT send your original documents by post. The University is not responsible for any documents lost in the post. Transcripts and diplomas which are not in English should be accompanied by a certified translation in English.
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Please tick as appropriate.
3.
ACADEMIC QUALIFICATIONS (attendance at education institutions after the age of 12 years)
Institution Level reached Period of attendance From To Degree or Diploma Date of award
Additional qualifications to be obtained by the coming August 31, if any Expected Date Qualifications
4.
PREVIOUS KNOWLEDGE OF CHINESE LANGUAGE
Language courses Period of attendance From To Qualifications obtained (if any)
5.
SPONSORING AUTHORITY (if applicable) __________________________________________________________________________________
6.
CURRENT EMPLOYMENT (if applicable) __________________________________________________________________________________
7.
REASONS FOR APPLYING THE COURSE __________________________________________________________________________________ __________________________________________________________________________________
8.
INTERESTS/HOBBIES __________________________________________________________________________________
9.
DECLARATION I declare that all information provided by me in this form is accurate.
______________________________________
Date CCL FORM MARCH 2007
__________________________________________
Signature of Applicant
THE UNIVERSITY OF HONG KONG Payment of Application Fee 1. The application fee is HK$300 (non-refundable). 2. Methods of Payment: Local applicants residing in Hong Kong:
(a)
Please pay the application fee, using one of the methods overleaf;
or
(b)
Please complete the form below for payment by credit card.
If you are using the payment methods in 2(a) above, it is essential that the original ATM customer advice / CQM transaction advice, or in the case of internet banking, a printed copy of the bank‟s acknowledgement statement which contains the payment reference number be stapled to your application form for submission to the University. Please retain a photocopy of the receipt as proof of payment of the application fee. Overseas applicants should pay by bank draft (in Hong Kong Dollars) drawn on a bank in Hong Kong and made payable to “The University of Hong Kong”, or by credit card (please complete the form below). CREDIT CARD PAYMENT Full name of applicant (as given on the application form): ____________________________________________ Please complete and attach this form to your paper application if you choose to pay the application fee by credit card. Credit Card (Please tick) Name printed on credit card (BLOCK LETTERS) Card Number Expiry Date VISA MASTER
- - - / (Month/Year)
To the Registrar: I hereby authorize The University of Hong Kong to charge HK$300 to the above credit card account to cover the application fee for Certificate in Chinese Language.
Signature of credit card holder: _________________________________ Date: __________________________ (Please use authorized signature as on your credit card.)
Methods of Payment (for Local Applicants only) Payment method Procedures Receipt to be attached to the application form Original ATM customer advice
ATM (Automatic Teller Machine)
1) 2)
Locate an ATM with „Bill Payment‟ function Select “Bill Payment”“Education”“The University of Hong Kong” (Please do not use the account transfer function for payment) Enter Bill Type: “06” Other Fees Enter Bill Account Number: For HSBC / Hang Seng Bank: 20999999834001 For JETCO: 2099999983000004001 Enter amount of payment: HK$300 Logon to any of the following websites: HSBC Hang Seng Bank JETCO BEA Make bill payment by choosing the following function: (Please do not use the account transfer function for payment) HSBC: View and Pay Bills Hang Seng Bank: View and Pay Bills JETCO: JET Payment BEA: Bill Payment / CyberPayment / JET Payment Select “The University of Hong Kong” as the merchant for payment Enter Bill Type: “06” Other Fees Enter Bill Account Number: For HSBC / Hang Seng Bank / BEA Bill Payment: 20999999834001 For JETCO / BEA CyberPayment / BEA JET Payment: 2099999983000004001 Enter amount of payment: HK$300 Make a crossed cheque payable to “The University of Hong Kong” and write your name at the back of the cheque (Post-dated cheque is not acceptable) Deposit the cheque at any HSBC‟s CQM by a) entering The University of Hong Kong‟s bank account number 002-222834-002 and the cheque amount of HK$300; and selecting “Reference” and entering the reference number: 20999999834001
3) 4)
5) Internet banking 1)
2)
A printed copy of the bank‟s acknowledgement statement which contains the payment reference number
3) 4) 5)
6) HSBC‟s CQM (Cheque Deposit Machine) 1)
Original CQM transaction advice
2)
b)
3)
Insert the cheque into the cheque insertion slot [For details, please refer to the instructions listed on the machine]
12/602 amended
THE UNIVERSITY OF HONG KONG Personal Information Collection Statement
1. This is a statement to inform you of your rights under the Personal Data (Privacy) Ordinance.
2. Personal information is provided by you as an applicant through the completion of application procedures and forms designated for various purposes, e.g. for admission to a programme of study, for the issuance of your student registration card, for an exchange programme, for hall admissions, and for provision of facilities or services. Data collected are used specifically for the purposes prescribed in the application forms and will serve (a) (b) (c) as a basis for selection of applications; as evidence for verification of the applicant‟s identity, examination results, academic records and other information; and where applicable, as part of the applicant‟s official student records.
In the case of (c) above, information so incorporated into student records will be used for all purposes relating to the student‟s studies as required by the relevant regulations and procedures of the University. 3. Personal data will be kept confidential and handled by the University‟s staff members. The University may transfer some of the data to an agent or other persons appointed to undertake some of its academic and administrative functions. 4. Under the provisions of the Ordinance, you have the right to request the University to ascertain whether it holds your personal data, to be given a copy, and to apply for correction of the data, if deemed incorrect. 5. Applications for access to and correction of personal data should be made by using a special request form and on payment of a fee. Such applications as well as requests for information should be addressed to the Data Protection Officer, Registry, The University of Hong Kong.
H.W.K. Wai Registrar
September 2006
THE UNIVERSITY OF HONG KONG
香 港
大 學
Date: ____________________ Dear Sir/Madam, Your application for admission has been received and is under consideration.
Academic Services Enquiry Office
Note: If you wish to receive an acknowledgment of your application, please write your name and address and affix stamp below.
Please affix stamp
Name:
Address: