Office of Service-Learning, Lingnan University

Mainland and International Service-Learning Program: SLSI 2016 Application Form

Office of Service-Learning (OSL), Lingnan University

Mainland and International Service-Learning Program (MISLP)Cross-Border Service-Learning Summer Institute (SLSI) 2016

Application Form

Application Deadline

1-Februrray, 2016 (Monday) 17:00 (HK Time)

Please read these notes and the Participant Agreement (on the SLSI website) before completing your application

Important notes:

(1)  The information provided in this form will be used for MISLP – Cross-Border Service-Learning Summer Institute (SLSI) 2016 participant selection only.

(2)  Application Instructions

We will accept only soft copies of all application materials. Submit this completed application (in .doc or .docx format) and your recommendation letter to with the subject heading “SLSI application_Full name_Year” by the application deadline. Please complete your entire application in English.

(3)  Conditions of Institute Sponsorship and Participation

v  If selected for SLSI, you will sign a Participant Agreement detailing all of your assignments and responsibilities before, during, and after the institute.

v  Those who fail to complete ALL the assignments and responsibilities in the Participant Agreement will forfeit their sponsorship (If any) and need to pay the full amount (HKD$15,000) of the institute fee themselves.

(4)  For more information

Office of Service-Learning, Lingnan University

Address: LBY101, Office of Service-Learning, Lingnan University, Tuen Mun, New Territories, Hong Kong

SLSI Website: www.ln.edu.hk/osl/SLSI/index.php

Email:

Contact Person: Ms. Chloe Siu at 2616 8178/

A.  Personal Information

Name (English) / ______(Last name)
______(First name) / Passport Size Photo Here
Name (Chinese, if any)
Preferred Name / Sex (M/F)
Date of birth (DD/MM/YYYY) / Age
Place of Birth (City, Country) / Nationality
E-mail
Address / City, Country
Zip Code (if any)
Mobile Phone Number / (+ )
Home Phone Number / (+ )
Hong Kong ID Card No.
( if applicable)
Type of Passport
Passport Number
Date of Expiry
China Card No. (For Hong Kong Student) ( if applicable)
Date of Expiry
University Name
Student ID Number
Major/Stream/Faculty
Year of Study
Program Nature (Undergrad, Post-grad, Exchange, Other)*

B.  Community / Extra-curricular Activities

Please list the extra-curricular activities and community activities of the last 2 years that demonstrate your leadership and responsibilities.

Organization / Agency / Position Held / Responsibilities / Date (Month / Year)
From / To

C.  Travel Experience

If you have visited other countries for study or holiday, please give the details below:

Date(s) of Visit / Country Visited / Reason for Visit / Length of Visit

D.  Language Skills

Please indicate your language proficiency levels.

The levels are: Native (N), Excellent (E), Good (G), Basic (B), Not Applicable (N/A)

Reading / Writing / Speaking / Listening
1.English
2.Mandarin
3.Cantonese
4. Other:

E.  Service-Learning Experience

Please list out the Service-Learning projects have you joined.


I. Service-Learning Research Scheme (Only applicable to Lingnan applicants)

Academic Year and Semester / Course Code / Course Name / S-L Project Name
Examples:
2012-2013 (Semester 1) / SOC 1203 / Social Gerontology / Be a Happy Person

II. Other Service-Learning experiences (Applicable to all applicants)

Other S-L Project Name / Date (Month / Year)
From / To

F.  Short Answer Questions (Please answer these questions in about 100 words.)

1.  Why are you interested in joining the SLSI?

2.  What does Service-Learning mean to you?

3.  What does Global Citizenship mean to you?

4.  What study element(s) in SLSI attract(s) you?

5.  What are your top 3 strengths and weaknesses?

Strengths / Weaknesses

6.  Social Issues Ranking

During SLSI, you will work with a small group for your service practicum and group work, focused on one of theme social issues. Please rank the social issues by your interest (1 being highest interest).

___ Active Ageing ___ Social Entrepreneurship ___ Other Social Issue Interests: (______)

G.  Essay Questions (Please answer these questions in about 300 words.)

1.  Please share your interested research idea about your chosen social issue (Active Ageing or Social Enterprises) and your perception towards the issue.

2.  What do you know about Hong Kong and Yunnan? What do you expect to learn throughout the institute?

H.  Other Information

1.  Have you ever applied for other international program(s) organized by OSL?

o Yes (Program(s): ______and time period: ______)

o No

2.  Will you or have you applied for other international / exchange program(s) organized by other departments / organizations?

o Yes (Program(s): ______and time period: ______)

o No

3.  Please write in the space provided if you have other information that you would like to give for your application.

I.  Declaration

I declare that I have read the Participant Agreement and Important Notes for this application. I also declare that, to the best of my knowledge, all the information included and attached to this application is accurate.

Applicant Name / Date


Cross-Border Service-Learning Summer Institute (SLSI)
Confidential Recommendation Form 機密推薦表格

To the Applicant 致申請者：

Submit this form to someone who is familiar with you, ideally a mentor, a teacher, an employer, or a co-worker. The referee should not be a friend or a family member. The recommendation form will be regarded as invalid if it does not have your referee’s signature or is incomplete.

請將此推薦表格交予一位熟悉你的推薦人。推薦人可以是你的導師、老師、僱主或同事等，唯家屬或朋友不能成為你的推薦人。若閣下未能提供: 1) 推薦人簽署 或2) 完整資訊，此推薦表格將不獲接納。

Name of applicant 申請人姓名 /

To the Referee 致推薦人：

CLE9027 Cross-Border Service-Learning Summer Institute (SLSI) is a 8-week summer course (with 3 credits) that has been offered for six years. In the Institute, Lingnan University (Hong Kong) students have a great chance to cooperate with exchange students from universities in mainland China, Japan, Korea, Singapore, Philippines, Taiwan and Indonesia.. Please feel free to visit to our web-site for more information: http://www.ln.edu.hk/osl/SLSI/index.php or facebook search “Cross-Border Service-Learning Summer Institute”.

This student has requested your recommendation to supplement his/her application for SLSI 2016. Please provide information about his/her character, academic abilities and community service interests; he/she can inform you more about the selection criteria. Your comments and information are very helpful for our selection of applicants. The information you provide will be used for SLSI participant selection only. You can write your recommendation letter in either English or Chinese. If this form is for a Lingnan applicant, please return the completed form to the applicant in a sealed envelope or by sending e-copy to . If this form is for an oversea applicant, please return the completed form by sending e-copy to .

CLE9027暑期服務研習所是一個為期8星期的暑期課程，嶺南大學服務研習處提供一個跨文化的學習平台，讓不同國家的大學生獲得國際性的服務研習體驗及探討其他全球性議題。如欲索取更多有關本計劃的資訊，可瀏覽計劃網頁(http://www.ln.edu.hk/osl/SLSI/index.php)或面書（搜索“Cross-Border Service-Learning Summer Institute”）。

請提供有關申請人的品格、學術能力及對社會服務的興趣等資料及評語。你提供的資料及評語將大大幫助我們甄選合適的人選。如有需要，請另加頁數。推薦內容只用於是次內地及國際服務研習計劃甄選過程之用。推薦信可以使用中文或英文書寫。若申請人為嶺南大學學生，。若申請人為海外學生，推薦人請將填妥的表格，。

Name of referee
推薦人姓名 / Title of referee
推薦人稱號或職銜
Company/ Organization
公司/機構 / Contact number/ e-mail
推薦人聯絡電話或電郵
Relationship to applicant
與申請人的關係 / The length of time that you have known the applicant
與申請人認識時間
Comments on the applicant 對申請人的評語 (Separate sheets if necessary如有需要，可另加紙張補充)

Signature of Referee
推薦人簽署 / Date
日期

Thank you very much for your kind help! 多謝你的協助!

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