HONG KONG BAPTIST UNIVERSITY
Academic Registry URGENT
2006 JUPAS Admissions Exercise (July Interview)
Request Form for Change of Interview Date/Time
To: Mr. Ben Fok / Ms. Helen Chan / Ms. Cherry Chan
Fax: 3411 7373 E-mail: firstname.lastname@example.org
(JUPAS Application No.)
(Applicant will be notified of the result of this request by mobile phone or via e-mail.)
I would like to request for a change of the scheduled interview date/time due to special circumstances
beyond my control, e.g. accident, illness. I understand that this request may be approved or not and I
will accept the decision made by the Academic Registry and the respective department in this regard.
The details of my request are as follows:
Course for interview: Course Course
REQUEST FOR A CHANGE TO
ORIGINAL ● Requested date and time are considered on an
Reasons for change of interview date/time:
Supporting documents attached: ___ No ___ Yes No. of pages attached =
For Office Use
(i) Department’s Consideration (to be replied (ii) Applicant to be notified of the decision by
* on / before: ____________________ ) * Department / Academic Registry via
e-mail / phone.
Request is __ approved __ not approved.
By: Date: By: Date:
(name in capital) (name in capital)
60c5d09b-382b-4535-89b9- Page 1 of 1 * Delete whichever is inappropriate.