Faculty of Arts, University of Hong Kong The University of Hong Kong
The University of Hong Kong
   
 Notes:
Please submit the completed form online before 5:00 pm on Dec 23, 2016 (Friday). Late or incomplete applications will NOT be accepted. Enquiries: cyrusc@hku.hk.

 SECTION A - PERSONAL PARTICULARS
Surname: Given name:
University no.*: Programme:
Correspondence address:
Mobile phone no.:
Home telephone no.:
E-mail address:

 SECTION B - ACADEMIC RECORD AND EXTRA-CURRICULAR ACTIVITIES
Current year of study (2016-2017):

For Year II or III student, CGPA of the second semester in 2015-16:
Year1 Year2 Year3

Majors/Intended majors: (1)    
(2)


English language proficiency (your TOEFL / IELTS result is required by the host university to consider your application).
Test Date of test(dd/mm/yyyy) Score - Writing                        Score - Speaking
TOEFL  
IELTS  
Do you speak any languages besides
Chinese (Cantonese/Mandarin) and/or English?

If yes, please specify:
Yes No

List 3 most significant scholarships/awards received and major academic achievements for the past 2 years: List the 3 most recent noteworthy extra-curricular activities that you have taken part in:
1.
2.
3.
1.
2.
3.

 SECTION C - PROPOSED HOST INSTITUTIONS
Please refer to the list of available host institutions in the FAEP Information Sheet and indicate your choice of time period. Rank your top three choices in order of preference with "1" for the highest priority, "2" for second priority and "3" for thrid priority. You may choose to list one university only but no more than three.

Ranking Name of Host Institution Duration of Exchange
1
2
3

 SECTION D - HKUWW EXCHANGE PROGRAMMES
Have you applied for the HKU Worldwide exchange programme? Yes No
If yes, please rank the top six institutions combining your selection under the HKUWW and FAEP. Please specify if they are HKUWW or FAEP:
Ranking Name of Host Institution Type Duration of Exchange
1
2
3
4
5
6

 SECTION E - FINANCIAL INFORMATION
In academic year 2016-17, I am receiving the following Scholarship / Financial Assistance:
(Please tick as appropriate)
Government Grants Amount(HK$)
Government Loans
Non-means tested loan scheme Amount(HK$)
Means tested loan scheme Amount(HK$)
University Financial Assistance Amount(HK$)
First-in-the-Family Education Fund Amount(HK$)
HKU Entrance Scholarships Amount(HK$)
HKU Foundation Scholarships for Outstanding Students Amount(HK$)
Other Scholarship
(Please specify: )
Amount(HK$)

 SECTION F - STATEMENT OF UNDERSTANDING
  1. I understand that all sections of this application must be completed and a 'Statement of Purpose' (in English) must be submitted in support of my application.

    I understand that the Faculty reserves the right to nullify my application should any section of this application form be incomplete or should the Statement of Purpose not be submitted along with this application form prior to the application deadline.

  2. I understand that my participation in the exchange programme is conditional upon:

    (a) my application being reviewed and approved by the Faculty of Arts, HKU;
    (b) my obtaining the necessary leave of absence from the Faculty with which I am registered;
    (c) my gaining admission to the host institution;
    (d) my maintaining a satisfactory academic standing; and
    (e) my returning to The University of Hong Kong to complete my studies.

  3. Since procedures and regulations vary from institution to institution, I understand that once I am officially accepted by a particular institution, any further arrangements or requests (e.g. applications for the buddy, airport pick-up, or homestay programmes) will be my own responsibility and I will be required to liaise directly with my host institution on these issues. I have noted that the Faculty of Arts will be available for consultation only and is under no obligation to provide any assistance or reminders with regard to these matters.

  4. I declare that the information given on this application is correct and I agree to abide by the rules and requirements of The University of Hong Kong (HKU) and the host institution as assigned by the Faculty of Arts Study Abroad Committee, failing which I shall be required to return to Hong Kong immediately and repay any scholarships/grants awarded in support of my exchange, in full or in part, at the discretion of the University.

  5. I have noted the general points pursuant to the Personal Data (Privacy) Ordinance (Annex I) and hereby permit HKU to release the information contained in this application to the host institution as assigned by the Selection Panel.


I agree to adhere to this Statement of Understanding*.
Statement of Purpose(in doc/docx format, max: 500Kb)*:
(Please put your name on every page of the Statement of Purpose)

Personal Information Collection Statement

The fields with an asterisk (*) must be completed. Otherwise, it cannot proceed.

 
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