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Hong Kong Baptist University

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					                             HONG KONG BAPTIST UNIVERSITY
                                     International Office
                  Room DLB 825, Level 8, David C. Lam Building, Shaw Campus
        Tel: (852) 3411 2188   Fax: (852) 3411 5568      Email: exchange@hkbu.edu.hk


                                       Application Fee
               (Applicable to Visiting Students from Non-Partner Institutions)
                                (Credit Card Payment Form)



Applicant’s Information:

Family Name: _______________________          Given Names: ___________________________

Home Institution: _______________________________ Country/Region: _______________

Email: _____________________________________________________________________

Tel. No.: _____________________________ Fax No.: _______________________________



Type of Credit Card (please tick as appropriate):

VISA CARD             MASTER CARD

Name on Credit Card: _________________________________________________________

Credit Card Number: __________________________________________________________

Expiry Date: _______________ _________________________________________________

Amount to be Charged:                          HK$400




Signature: _________________ (As appeared on credit card)        Date: _________________




Note:   Please complete and submit this form together with the completed Application for
        Enrollment to the International Office.

				
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