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					Application for Admission to Research Postgraduate Programmes (MPhil / PhD) Application Fee - Credit Card Payment Form
Applicant Information: (Please tick as appropriate.) Family Name: Programme Applied for: Department Applied for: Telephone No.: Email Address: Credit Card Information: (Please tick as appropriate.) Type of Credit Card: Credit Card No.: Expiry Date:
Month

First Name:

 PhD

 MPhil

Fax No.:

 Visa Card

 Master Card

 Others:

/
Year

Name of Card Holder (in English): Amount:

 HK$200 (Online Application)  HK$400 (Paper Application)
Date:

Signature of Card Holder: Note:

Please submit this form together with the completed application form to the Office of Graduate School. Should you have any further enquiries, please do not hesitate to contact us by fax [(852) 3411-5133] or by email [rpgs@hkbu.edu.hk]. __________________________________________________________________________________
Personal Data (Privacy) Ordinance Personal Information Collection Statement Persons who supply personal data in their applications to the Office of Graduate School for various purposes are requested to note the following: 1. 2. 3. Personal data provided in the applications are to facilitate the processing of their applications and will not be used for other purposes. Personal data provided will only be used by University staff. Application forms will be destroyed 3 months after the whole process is over.

Under the provision of the Personal Data (Privacy) Ordinance, request for personal data access or correction may be made and addressed to: Office of Graduate School (Level 7, Fong Shu Chuen Library, Ho Sin Hang Campus) Hong Kong Baptist University Kowloon Tong Kowloon

2009