Chung Chi College, the Chinese University of Hong Kong

CHUNG CHI COLLEGE, THE CHINESE UNIVERSITY OF HONG KONG

Notes to Applicants

Chung Chi College Admission Scholarship for Outstanding Extra-curricular Performance

New students with special talents admitted to The Chinese University of Hong Kong and Chung Chi College will be eligible for consideration of a one–off half tuition Fee Scholarship (HK$21,050) in their first year of study if they have demonstrated outstanding performance in one of the following three aspects:

a) Art and Music

b) Sports

c) Science and Technology

Submission of Application

Completed application form should be submitted

by e-mail: (Attn: Ms Dora Cheung) or

by fax : 2603 6505(Attn: MsDora Cheung)

On or before 13August2016 (Sat), 3:00pm.

Selection and Announcement of Results

Interviews will be held on15August 2016 (Mon).

Shorted-listed applicants will be invited to interviews provided that they have selected Chung Chi College as theirfirst college preference after they are admitted into The Chinese University of Hong Kong.

Shorted-listed applicants will receive notification of the interview details from ChungChiCollege directly. All supporting documents should be presented at the interview.

The Selection Panel reserves the final decision of awarding the number of the Awards.

Awards will only be announced after selected candidates are offered admission to Chung Chi College in mid-September 2016.

Enquiries

Contact Person: / Ms Dora Cheung
Tel: / 3943 4004
Address: / 4/F, Pommerenke Student Centre,Dean of Students’ Office,
Chung Chi College, The Chinese University of Hong Kong,
Shatin, N.T.,H.K.

CHUNG CHI COLLEGE, THE CHINESE UNIVERSITY OF HONG KONG

Chung Chi College Admission Scholarship for Outstanding Extra-curricular Performance 2016/2017

Application Form

Application Deadline:
13 August 20163:00pm

Please read the “Notes to Applicants” carefully before completing this application form.

1.PERSONAL PARTICULARS

Name: (English)______(please underline the surname) (Chinese)______
Sex_: ______Telephone no.(mobile):______(home):______
E-mail address:______
Home Address:______
______
Admitted Programme in CUHK / :______

2.ACADEMIC QUALIFICATION

1. EducationPlease list in chronological order. Photocopies of certificates and transcriptsshould be presented at the interview.

From
Month/year / To
Month/year / Name of Institution/School / Qualifications obtained
(Study level/major subject)

1. HKDSE ResultsPhotocopies of certificates and transcriptsshould be presented at the interview.

Year / Examination / Subject / Grade / Subject / Grade
HKDSE / 1. / 2.
3. / 4.
5. / 6.
7. / 8.

3.NON-ACADEMIC PERFORMANCE/QUALIFICATION

1. Extra-curricular Activities:Secondary & Post-Secondary(both on and off campus)

Please give details of the most important (up to FIVE) Extra-curricular Activities participated.

From
Month/year / To
Month/year / Organization/Activity / Post and Description

1. Award/Prize/Qualification obtained:

Please give details of the most important (up to FIVE) Award/Prize/Qualification obtained.

Photocopies of certificates should be presented at the interview.

My Award/Prize/Qualification obtained belongs to the following field(s):( please tick as appropriate)
□ArtMusic □ Sports □Science and Technology
Year / Type# / Award/Prize/Qualification and Description / Organization
My Award/Prize/Qualification obtained also belongs to the following field:
□Others, please specific: ______
Year / Type# / Award/Prize/Qualification and Description / Organization

# Type of Award/Prize/Qualification: Please state “I” for International; “R” for Regional; “L” for Local

4. SELF RECOMMENDATION

In Chinese or English (not more than 500 words).

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5. DECLARATION

I, ______(full name in English), certify that the particulars given above are correct and complete, and I understand that any mispresentation will disqualify my application for the award.

I understand that, to be qualified for the award, I must fulfill the eligibility and be admitted to The Chinese University of Hong Kong and Chung Chi College in September 2016 to undertake undergraduate studies.

I hereby give consent to disclose my personal data to necessary persons/organizations for the purpose of processing the award.

Signature of Applicant:______Date: ______