Certification 01 2010

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					                                                                                                                                   (01/2010)

                                                                                   Chow Yei Ching School of Graduate Studies
                                                                                   Taught Postgraduate Student Records Service Counter
                                                                                   Unit 6B, Block 1, To Yuen Building
                                                                                   Tel No.: 3442-9014         Fax No.: 3442-0237
                                                                                   Email:    tpenquir@cityu.edu.hk


                                                Application for Certification
Please read the Notes to Applicants overleaf before completing this form.
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Student Name: _____________________________                        Student No.

Day-time Contact Phone No.: _________________                     HKID/Passport* No.

Programme Enrolled (Code and Title): ____________________________________________________________

Mode of Attendance: FT/PT/Combined*                               CityU Email Address: ____________________________
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Application Particulars (Please tick as appropriate)

      To certify the normal duration of the enrolled programme

      To certify the classification of award
      Extension of student visa – (For mainland student, please see Note 4 overleaf)
      To issue a “Certification of Study” letter to the HKSAR Immigration Department for application of
      further stay in Hong Kong under the Immigration Arrangements for Non-local Graduates (IANG)
      after completion of studies at CityU
      Others – (please specify): ____________________________________________________________
_____________________________________________________________________________________
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Collection of Certification (Please tick as appropriate)

Number of Certification(s) required (HK$30 per page) : ____________

      I wish to collect the certified academic document(s)/record in person.

      Please mail my certified academic document(s)/record to ___________________________________

      I will authorise another person to collect the certified academic documents/record on my behalf.
      (Please complete the Authorisation Letter. For details, please see Note 2 overleaf.)


__________________________________                                                              ______________________________
                 Signature                                                                                         Date
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Certification Received By


__________________________________                                                              ______________________________
                 Signature                                                                                         Date
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(For Office Use Only)

     Visa/Master Card                   EPS             Receipt Attached                  Received by __________________

Prepared by _______________________________                                         Sent on ____________________
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*       Please delete where inappropriate


Use of Information: Information provided in this form will be treated as strictly confidential and will be used by the University
                     for checking of records only.
                                             Certification


Notes to Applicants

1. Students may apply for various certifications in respect of their studies at the University.

2. Students may authorise a third party to collect the certification documents on their behalf. In this
   connection, the authorised person should present the following upon collection of the certification
   documents:
   • An authorisation letter signed by the student concerned [an authorisation letter template is
       available at the “Form Download” section of the SGS website (“http://www.cityu.edu.hk/sgs”)
       or SGS Taught Postgraduate Student Records Service Counter].
   • A copy of the student identity card/HKID card/passport of the student concerned (this will be
       returned to the authorised person after inspection)

3. Certifications sent overseas will be by regular air mail. CityU will not be responsible for any
   mishandling of mail.

4. For mainland students who need certification for an extension of their student visa, please return
   the completed application form in person to the SGS Taught Postgraduate Student Records Service
   Counter with their original Travel Document (通行証).



Procedures for Application

Application can be made by post or in person at the SGS Taught Postgraduate Student Records
Service Counter together with payment of the required fees. Students should apply at least two weeks
before the date the certification is required to allow adequate time for processing.



Fees Payment

Please pay by one of the following methods:

a. by direct deposit at any branch of the Hang Seng Bank
   (CityU current account no.: 293-318028-004); or

b. by electronic transfer to the above CityU account at any Hang Seng Bank ATM machine; or

c. by Visa/Master Credit card or EPS at the SGS Taught Postgraduate Student Records Service
   Counter; or

d. by bank draft in Hong Kong dollars payable to “City University of Hong Kong” (for overseas
   applicants)

For fees settled by method (a) or (b) above, please attach the original receipt to the application form as
proof of payment.

				
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