Applicant’s Name:
Application Period: 9th November - 20th December, 2015
Application Form
*Please read through the programme details on our website (http://web.swk.cuhk.edu.hk/home/leadership) before application. E-mail notification will be sent to applicants when forms are received. Please contact us if you do not receive any notification within 5 working days.
English Full Name: / Chinese Full Name (if applicable):Salutation:
☐Mr. / ☐Miss / ☐Dr.
Organization: / Nature of Organization:
☐NGO
☐Non-NGO
Position:
Main Duties:
Academic Qualification Obtained:
Institution of Learning/ Training / Qualifications Obtained
(Please specify country, if not in Hong Kong) / (Please state programme(s))
1.
2.
Brief Description of Your Past Working Experience:
Your Vision in Social Service:
Expectations of the Programme:
E-mail Address: / Phone Number:
I am signing to declare that the information provided above is true. I understand that the application could be withdrawn should any of the above is proved to be false. I have read and agree to the programme details stated on the programme website: http://web.swk.cuhk.edu.hk/home/leadership.
Signature: / Date:
Please submit the application and recommendation form separately. You may submit the form by e-mail at / fax: 2603-5018/ post: “Department of Social Work, CUHK, Shatin (Attn: NGO Leadership Programme)”.
Enquiry: 3943-6049
The personal data provided on application forms are used by the Department of Social Work, CUHK, only for enrolment and course administration. All personal data collected will be treated as strictly confidential. Under the provision of the Personal Data (Privacy) Ordinance, applicants have the right to request access to and make correction of their personal data. Applicants wishing to make amendments on personal data should submit written requests to the Department by e-mail to .
1/4
Applicant’s Name:
Recommendation Form
(to be filled by applicant's supervisor)
**Please submit this recommendation form and the application form separately**
Referee's English Full Name: / Salutation:☐Mr. / ☐Miss / ☐Dr.
Phone Number: / E-mail Address:
Organization: / Position:
Nature of Organization: / (Organization Chop)
☐NGO
☐Non-NGO
(Please fill in either English or Chinese)
What do you expect the applicant to be benefited from the Programme?
Additional information for assessing the application:
Signature: / Date:
Please submit the application and recommendation form separately. You may submit the form by e-mail at / fax: 2603-5018/ post: “Department of Social Work, CUHK, Shatin (Attn: NGO Leadership Programme)”.
Enquiry: 3943-6049
The personal data provided on application forms are used by the Department of Social Work, CUHK, only for enrolment and course administration. All personal data collected will be treated as strictly confidential. Under the provision of the Personal Data (Privacy) Ordinance, applicants have the right to request access to and make correction of their personal data. Applicants wishing to make amendments on personal data should submit written requests to the Department by e-mail to .
1/4