APPLICATION FOR BURSARY

Application Form

PART A - Personal Particulars

Name / (English) / (Chinese)
Date of Birth / Place of Birth / Sex
HKID Card No. / Passport no. (if not a
HKID card holder)
Nationality / Country issuing Passport
Home Address
Tel. No. / (Home) / E-mail
(Mobile)
Length of stay in Hong Kong / (Since / )

PART B – Application

I wish to apply for financial assistance in my study of the following course:

Name of school
Course of study
Duration
Course fee
*Current status of enrolment

* Please provide supporting documents, e.g. copies of student card, enrolment slip, acceptance of enrolment application, etc.

PART C – Academic Background

Name of School (s) / Study completed / Year / Certificate attached

PART D - Family Particulars

Father’s Name (English) / (Chinese) / Age
Mother’s Name (English) / (Chinese) / Age

Total number of persons in the same household and relationship with the applicant (apart from parents):

Name (English) / Name (Chinese) / Age / Relationship

PART E – Financial Information

Father’s principal employment

Name of employer:

Position:

Date of joining:

Salary:HK$ per month

Allowance: HK$ per month

Other income: HK$ per month

Total savings/assets: HK$

Mother’s principal employment

Name of employer:

Position:

Date of joining:

Salary:HK$ per month

Allowance: HK$ per month

Other savings/assets: HK$

Total savings/assets: HK$

Other income

Description / Income (HK$)
Total

Please provide supporting documents to substantiate the financial position stated in this application including copies of employment contracts, bank passbooks, salary receipts, etc.)

Costs of living and accommodation

Amount paid
(HK$)
Monthly rental / mortgage installment in respect of the current residence
Rates and government rent per month
Monthly insurance premium in respect of the above mortgage
Total

Other expenses

Amount Paid
(HK$)
Pension, retirement scheme contributions or provident fund contributions per month
Salary tax per month
Other expenses per month, please specify:
Total

Part F – Other Scholarships and bursaries

If you have obtained or have applied or will apply for other scholarships or forms of financial assistance in relation to the subject matter of this application, please list the names and amounts of the scholarships or forms of financial assistance you have obtained, applied or will apply.

Name of Scholarship / Awarding Organisation / Amount of award (HK$) / Status of Application

Please provide supporting documents to substantiate the costs of living and accommodation and all other expenses including copies of demand notes for rates, rental, mortgage payments, and other utilities, MPF contributions, tax returns, etc.)

STATUTORY DECLARATION

I, ______, of ______, solemnly and sincerely declare that:-

  1. The information I provide in this application and in support of this application is true and correct and complete to the best of my knowledge and belief. I understand that my application will be disqualified if any information or document provided is found to be false.
  1. I have read the Personal Information Collection Statement attached to the application form.
  1. I authorise Hong Kong Academy of Law to use, check and process my data as required for my application.
  1. I understand that upon application, my data will become a part of my record and may be used for all purposes in connection with the processing of the application and the granting of the bursary award where the application is successful.

And I make this solemn declaration conscientiously believing the same to be true by virtue of the Oaths and Declarations Ordinance Cap.11.

______

(Holder of Hong Kong identity card no. )

Declared at ______in Hong Kong this ______

Before Me

______

Personal Information Collection Statement

  1. This is a statement to inform applicants of their rights under the Personal Data (Privacy) Ordinance.
  1. The personal data collected in the application form will be used by Hong Kong Academy of Law for the purposes of evaluating the merits of the application and where applicable, will serve as part of an applicant’s official record with the Academy.
  1. Personal data will be kept confidential and handled by the staff of or persons appointed by Hong Kong Academy of Law to undertake its administrative functions.
  1. Under the Personal Data (Privacy) Ordinance, an applicant has a right to request access to, and to request correction of, his personal data in relation to his application. To exercise these rights, please complete our Personal Data Access Form (which is available at the offices of the Academy or at the website at and forward it by post or by e-mail to:

The Secretary

Hong KongAcademy of Law Limited

3/F Wing On House

71 Des Voeux Road

Central, Hong Kong

E-mail:

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