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Request for Routing the Student Visa Application

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					             Request for Routing the Student Visa Application
           through the School of Humanities and Social Science,
             Hong Kong University of Science and Technology

I, _______________________________________(name in block letters), have been selected
by _________________________________________________ (name of student’s home
university) to participate in the student exchange program with the School of Humanities and
Social Science, the Hong Kong University of Science and Technology (hereafter referred to
as “HKUST”) for 2010-11. I would like to route my student visa application through HKUST.
By doing this, I understand that HKUST will be picking up the student visa label from the
Hong Kong Immigration Department when my application is approved. HKUST will then
send the visa label to me by registered mail or when necessary, by courier, to the address that
I put down on the attached “Address Form on Student Visa”. I will inform HKUST if my
mailing address changes at a later time.


It is my responsibility to pay the visa fee, which is currently at the rate of HK$160. I
understand that the actual charge is subject to revision without prior notice. I agree to pay this
amount to HKUST by credit card so that HKUST can settle the visa fee on my behalf when
picking up my visa label. Should the visa fee be revised at a later date or the credit card that I
supply below be rejected, I agree to pay the balance to HKUST upon my arrival at HKUST.


I understand that the visa fee is non-refundable once it is paid to the Hong Kong Immigration
Department. As such, I will not be able to get the visa fee back if I decide to withdraw from
the exchange program after the visa fee is paid.


Signature: ________________________ Date: __________________


Card Information for Payment of Visa Fee:
By Visa _____ (please check against the right box by using a “√”)
Master Card _____
AMEX _____
        (HKUST only accepts the above credit cards)
Cardholder’s Name: ______________________________
Card Number: ______________________________
Expiry Date (mm/yyyy): ______________________________
Authorized Amount: HK$160
Cardholder’s Signature: ______________________________
*********************************************************************
If you wish to route your application for student visa through HKUST, please return this form
to HKUST along with your completed visa application package by 6 December 2010.

HSS-EX 03

				
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