Application Form for Admission to Undergraduate Degree Programmes For Non-local Applicants
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1 Admissions Section, Academic Registry Application Form for Admission to Undergraduate Degree Programmes For Non-local Applicants For Office Use Received on: Application Number: N16 Please submit the completed form with relevant supporting documents Part A Personal Data (Write in block letters) Name (Name on HKID/ Passport/ Mainland ID/ Travel Document) Surname Other Names 中文姓名 ( 如適用 ) Sex (F/M) Date of Birth H.K.I.D./ Passport/ Mainland ID/ Travel Document No.* Correspondence Address year month day * Delete whichever is inapplicable. Home Phone No. - Mobile Phone No. - Fax. No. - Address (An address must be provided as correspondence will be sent via ) If you need to apply for student visa in order to study in Hong Kong, please specify the country of origin: If you are currently studying or residing overseas, please tick the box. If you are a non-chinese speaking applicant, please tick the box. If you are applying on the strength of overseas qualification (highest qualification), please specify the country or region of the qualification(s) received: Part B Study Year Apply For (Please tick one box only; please refer to Part B of Notes on Application) Year 1 Year 3 Part C Choice of Undergraduate Degree Programmes (Please refer to Undergraduate Prospectus [2016 Entry] for details) Choice First Programme Title Second Part D Applicant with a Disability (Please refer to Part D of Notes on Application) Are you a student with a disability? No Yes If yes, please indicate the nature of disability and attach the supporting document of your disability. Attention Deficit/Hyperactivity Disorder Autism Hearing Impairment Mental Illness Physical Disability Specific Learning Difficulties Speech Impairment Visceral Disability Visual Impairment Multiple Types of Disabilities Others ( Non-local applicants are defined as persons entering Hong Kong for the purpose of education with a student visa/ entry permit issued by the Director of Immigration.) 1
2 Part E Application Category (Please refer to Part E of Notes on Application) Please tick () one category only which reflects the HIGHEST qualification you have attained; or you may put a tick () beside Mature Applicant if you do not belong to any of the following categories below but are aged 25 or above on September 1, Associate Degree ( 1 of the 3 boxes below) Non-final year student Final year student Holder Degree Holder *Bachelor/ Master/ Doctoral (* Delete whichever is inapplicable) GCE Applicant (Applicants with GCE A-Level/ International Advanced Level (IAL) results) Diploma ( 1 of the 3 boxes below) Non-final year student Final year student Holder International Baccalaureate (IB) Diploma Holder/ Student Mature Applicant (Parts H to I must be filled in) Higher Diploma/ Professional Diploma ( 1 of the 3 boxes below) Non-final year student Final year student Holder Transfer Applicant (Current students of recognised local institutions who are enrolled in a full-time or sandwich UGC-funded or self-financed degree programme or students who are studying at an overseas education institution recognised by the University. Transfer students who have completed at least one year of study of a 3-year degree programme or two years of study of a 4-year degree programme may apply for Year 1 or Year 3 entry. Transfer students who are studying the first year of study of a 4-year degree programme are eligible to apply for Year 1 entry only.) SAT Applicants (Applicants with High School Graduation Diploma, SAT Test and SAT Subject Tests/ Advanced Placement (AP) results) Other Qualifications ( Applicants who possess qualifications other than those stated may apply under the category Others and will be considered for admission on a case-by-case basis. Other equivalent overseas qualifications are available at Part E of Notes on Application.) Part F Academic Qualifications & Examination Results Please list details of your education background, academic qualifications and examination results in chronological order in the following tables: 1. Years of Schooling Please fill in the years of schooling you have completed/ will complete at different education levels by August 31, Repeated study/ short courses should not be included into the counting of years of schooling. Primary Education Education Level Secondary Education Post-Secondary Education Years of Study (Please state no. of years by August 31, 2016) Study Mode (Full-time/ Part-time/ Distance-learning) 2. Secondary Education Name of Secondary School and Country/ Region Level Attended/ Attending Period (YYYY/MM) from to Qualifications Obtained/ To be Obtained (GCSE/ IGCSE/ GCE, IB, SAT and other public exam results) 2
3 3. Post-Secondary Education Name of College/ University and Country/ Region Level Attended / Attending e.g. Year 2 Qualification Obtained/ to be Obtained e.g. Associate Degree Period (YYYY/MM) from to Study Mode (Full-time/ Part-time/ Distancelearning) Programme Duration (Please state no. of years) Programme Title & Major Study e.g. Associate of Arts Business LATEST Cumulative GPA / Average Score 4. Public Examination Results a. GCE/ IAL Examination Public Examination Year of Subjects Taken and Grades/ Subjects To Be Taken GCE/IAL* A-Level GCE/IAL* AS-Level GCE O-Level/ GCSE/ IGCSE* *Delete whichever is inapplicable b. International Baccalaureate (IB) Examination Public Examination Level Year of Higher Level Subjects Taken and Actual Scores/ Subjects To Be Taken and Predicted Scores IB Standard Level Theory of Knowledge and Extended Essay c. Other Public Examination (e.g. SAT, AP, Mainland National Joint Entrance Examination (JEE)) Public Examination Year of Country/ Region Subjects Taken and Grades/ Subjects To Be Taken d. Other English Language Qualification Examination Year of Score Examination Year of TOEFL Paper-based Computer-based Internet-based Others (Please specify) Score / Grade IELTS (Academic Level) Listening Reading Writing Speaking Overall Band Score 3
4 e. Music Qualification (Applicants applying for Bachelor of Arts in Music programme MUST complete this section.) Please indicate your highest attainments in respective instrument(s) in the Associated Board of the Royal Schools of Music or its equivalence in the space below. Item Grade Score Year attained/to be attained Music Theory Instrument(s) Part G Other Academic/ Professional Qualifications Registered Social Workers who intend to apply for admission to Bachelor of Social Work programme are required to indicate his/ her professional qualification in this section. Professional Body and Country Name of Award/ Qualification/ Examination Level/ Grade Date of Award Part H Work Experience (Including Full-time, Part-time and Relevant Voluntary Work) (Only applicants applying under the category Mature Applicant are required to submit proof of professional qualifications or relevant work experiences) from Date (YYYY/MM) to Name of Organization Post Duties Work Mode (Full-time/ Part-time/ Voluntary) Part I Personal Statement (Optional) Please write no more than 600 words either in English or Chinese which may be helpful to your application, such as reasons for application, career aspiration, personal strengths, hobbies and interests, voluntary services, etc. Use separate sheet if necessary. 4
5 Part J Sports Achievement (Applicants applying for Bachelor of Arts in Physical Education and Recreation Management programme MUST complete this section.) Please state below, either in English or Chinese, whether you are National/ Regional Team Member or Tertiary Institution Team Member. Please also state the name of the sport or the event, the year and the world / local ranking that you had / have participated in. You should refer to Part J of Notes on Application for reference. Use separate sheet if necessary. 5
6 Part K Declaration (Please do not delete any item of this part) Applicants are required to make the following declaration before proceeding: 1. I declare that I have read and I understand the General Information for Online Application and Instructions on Completing the Online Application for Admission to before submitting my application. 2. I declare that the information set out in this application is, to the best of my knowledge, accurate and complete; and I agree to provide the original certificate or official certification for verification of my qualifications (including HKBU qualifications) upon request by the University. I understand that this information will be used in the admission decision process. I accept that if, in reading and completing this application, I knowingly or carelessly provided untrue or incomplete information, or I fail to provide the original certificate or official certification for verification, any offer of admission, whether accepted or not, may be withdrawn by the University and/ or I may be required to withdraw from any programme which I am enrolled in and all fees paid will not be refunded or transferred to another year/ other application. 3. I authorise the University to use the information, including but not limited to my name, address, phone number and address, I provide in the application, for various types of processing in relation to my application. 4. I authorise the University to obtain, and the relevant examination authority, assessment body or academic institution in Hong Kong and elsewhere to release, information about my public examination results, records of studies or professional qualifications if deemed appropriate. 5. I authorise the University to use my data to carry out checks of my application and any records of my studies in the University and other institutions in Hong Kong and elsewhere if deemed appropriate. 6. I authorise the University to check, and the relevant parties to release, my employment records if deemed appropriate. 7. I understand that, upon my enrolment in a programme, relevant data will become part of my student record and may be used for purposes in accordance with the procedures of the University. 8. I understand that the whole application procedure will be processed online, and it is my responsibility to check all message(s) sent by the University via / phone/ SMS/ Applicant Enquiry System which may contain important information regarding my application. 9. I understand that I may request for access to or correction on my data in accordance with the provisions of the Personal Data (Privacy) Ordinance, Cap. 486 and I can make such request(s) to the University. 10. I understand that the University may use information in my application for statistical and research purposes on the basis that no information that could identify me (such as name, address, phone number or address) will be published. 11. The University could use my data in direct marketing such as advertising or promoting its programmes. I understand that the University may not do so without my consent. I understand that I can withdraw my consent at any time. Signature Date 6
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