HONG KONG INSTITUTE OF VOCATIONAL EDUCATION CHAI WAN APPLICATION

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					                     HONG KONG INSTITUTE           OF VOCATIONAL             EDUCATION        (CHAI WAN)

                                       APPLICATION FOR STATEMENT OF RESULT

    Pleasereadthe instructionsoverleafbeforecompletingthis form.
    I.       PARllCULARS OF STUDENT

             Name (*Mr./Miss/Ms.)



                                                            if
                                                 (in Chinese, applicable)

             CourseTitle                                                     Course Code I    I    I       I   I   I   I

             Department                                                      Mode of Attendance: *FT/PTE/PWR

             Address                                                          Tel.No.                                      (Home)
                                                                                                                           (Office)
                                                                                                                           (Mobile)

                             of
             Type of Statement Resultapplied for                      *TC/IVE (seenote overleaf)
                   for
             Reason application:                                      Lost/Damaged*
             Have you applied for any Statement Resultbefore?
                                              of                      YES/NO*
             The date(s)of my previousapplication(s)* is/are


                                                                Signatureof Student
              .Please deleteas appropriate.

    II.       ACKNOWLEDGEMENT (To be completed by student upon collection of Statementof Result)

              I acknowledge                      of
                           receiptof the Statement Result,serialno:

                                                                 Signatureof Student

    (For Office Use)
    III.     RECORD AT THE CAMPUS SECRETARIAT                      tick
                                                            (Please the appropriateboxes)

             All itemsduly filled in by applicantin SectionI
             Hong Kong ID Card checked
             Registerof Certificatechecked
             Record of previous applicationchecked
                                 of
             Acknowledgement applicationissued(dateavailablefor collection                             )

              Remarks

                                                                Signature

              RECORD AT THE FINANCE OFFICE
                                                             No.
              A handlingfee of HK$1 00 hasbeenreceived(Receipt

                                                                 Signature

    v.        ISSUE OF STATEMENT OF RESULT

              Student'sHong Kong ill Cardchecked

                                                                 Signature
                                                                                                  COII(AR)
     Stat~t_result_fonn   [rev 5/03)




D
                                       Instructions to Applicant

          Complete Part I of the application fonD and submit it together with your HKID card (for
          verification) to the Campus Secretariatin person.

     2.   Paya handlingfee of HK$l 00 which is non-refundable.

                                                              of
          ObtainReceiptof payment(VTC-66) andan Acknowledgement application.

     4.   Collect the Statementof Result in person on the date specified on the Acknowledgement by
          producing your own HKID card, noTnlally 5 working days after application.

                                                             receipt.
          CompletePart n of the applicationform to acknowledge


          The Hong Kong Technical Collegesand Technical Institutes have been amalgamatedto
          become the Hong Kong Institute of Vocational Education in 1999. Graduatesof year
                                                                           of
          2000/2001or before may opt to chooseeithera TC or an lYE Statement Result.




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