St. Teresa's Hospital School of Nursing
Professional Diploma in Nursing
(Enrolled Nurse to Registered Nurse Conversion Programme)
Start Date / : / May 2018Study Mode / : / Part-time
Duration / : / 3 years
Level of Qualification / : / Qualification Framework Level 5. Graduates will be eligible to register with the
NCHK as a Registered Nurse (General).
Course Fee / : / Year 1 $50,000
Year 2 $50,000
Year 3 $50,000
Entry Requirements / : / 1.Be an Enrolled Nurse with the NCHK licenses;and
2.Attain a Higher Diploma/ Associate’s degree in any discipline from a recognized institute (or equivalent);and
3.Satisfy minimum entry requirements for Registered Nurse training set by theNCHK.
Application Fee / : / HK$200 (Non-refundable)
Application Deadline / : / 29 Jan 2018 (Subject to postmark)
Submission:
/ : / 1.Please refer to “What’s New” download the Application Form and the recruitment details.
2.Completed application form together with the non-refundable application fee HK$200 in the form of a crossed cheque or bank draft made payable to “ST. TERESA’SHOSPITAL”.
3.THREE stamped self-addressed envelopes with sufficient postage. in person isacceptable.
4.Photocopies of the applicant’s relevant certificate [e.g. Certificate of Enrolled Nurse (Nursing)] MUST beattached.
5.Above document should be returned to : School of Nursing, St. Teresa’s Hospital 2/F, 20 LOMOND ROAD,KOWLOON
Please indicate “Application for Professional Diploma in Nursing”
on the cover of the envelope.
Notification of
Interview / : / If you are selected for interview, you will receive an individual notification via
email, mail or telephone.
Remarks / : / 1.This programme is accredited by the Nursing Council of Hong Kong (NCHK) and the Hong Kong Council for Accreditation of Academic and Vocational Qualifications(HKCAAVQ).
2.Students should purchase professional indemnity insurance on theirown.
3.Students need to take the body checkup and expenses will be on theirown.
Enquiries / : / Website:
Email: Telephone: 22003124
St.Teresa’s HospitalVersion1
Schoolof NursingSCHN-PRO-011
聖德肋撒醫院護士學校
Application for Admission
課程入學申請表
Higher Diploma in General Nursing (Enrolled Nurse)Programme
普通科護理高級文憑(登記護士)
Professional Diploma in Nursing (Enrolled Nurse to Registered Nurse ConversionProgramme)
護理專業文憑 (登記-註冊護士轉制課程)
Please complete the application form in English and print in BLOCK LETTERS
請以英文正楷填寫此申請表
Notice of Applicant
The personal data collected in this application form will be used by the School of Nursing, St. Teresa’s Hospital for the purpose of processing the application for the Higher Diploma in General Nursing (Enrolled Nurses) Programme. It is our policy to retain the personal data of unsuccessful applicants for a period of 1 month following the commencement of the programme. Under the Personal Data (Privacy) Ordinance, you have a right to request access to, and to request correction of, your personal data in relation to your application. If you wish to exercise these rights, please contact staff of the School.
申請人須知
本校會將本申請表所收集的個人資料，使用於處理申請報讀普通科護理高級文憑(登記護士)課程之用。根據本校政策,未被取錄之申請人的個人資料將會由課程開始後保留壹個月。根據〈個人資料(私隱)條例〉,你有權要求查閱及改正申請表上所填報的個人資料。如你欲行使這項權利，請聯絡本校職員。
Section I. Personal Particulars 個人資料Full Name in English 英文全名(姓氏先行) / Name in Chinese 中文姓名
Sex 性別 / Date of birth 出生日期
(dd/mm/yyyy) (日/月/年) / HK Identity Card No.
香港身份証號碼 / Religion 宗敎
(Optional 如適用)
Residential Address 住址
Correspondence Address 通訊地址(If different from the address given above 如與住址不同)
Residential Telephone No.
住所電話號碼 / Office/ Day Time Contact No.
辦事處/ 日間聯絡電話號碼 / Mobile Phone No.
流動電話號碼 / Fax No.
傳真號碼 / Email Address
電子郵件地址
*Please print clearly your email address for
contact.
*請清楚列明閣下的電郵地址，以便聯絡.
Section II. Educational Qualifications教育資歷
/ Schools Attended (Secondary/ Tertiary)
曾經就讀的學校(中學/專上) / Form
班級 / Year
年
In Hong Kong 在香港就讀 / 至 / 至
To / To
To / To
To / To
To / To
Outside Hong Kong 在香港以外地方就讀 /
至 / 至
To / To
To / To
To / To
Application Form / page 1 of3
Section III. Educational Qualifications (Continued) 教育資歷(續)Subject
科目 / HKDSE
SUBJECTS TAKEN
(Highest Grade Only)
香港中學文憑校本評核與考科目
(只填寫最高等級) / HKCEE
SUBJECTS TAKEN
(Highest Grade Only)
香港中學會考與考科目
(只填寫最高等級) / HKALE
SUBJECTS TAKEN
(Highest Grade Only) 香港高級程度會考與考科目
(只填寫最高等級) / IGCSE/GCE (A/O Level)
SUBJECTS TAKEN (Highest
Grade Only)
普通教育文憑試與考科目
(只填寫最高等級)
Total score (best 6 subjects)
Subject
科目 / Year
年份 / Grade
等級 / Year
年份 / Grade
等級 / Year
年份 / Grade
等級
A Level / Grade
等級
O Level / Year
年份 / Grade
等級
AS / Grade
等級
AL
Chinese Language
English Language (Syllabus A)
English Language (Syllabus B)
Mathematics (Compulsory part)
Mathematics (Extended Module 1)
Mathematics (Extended Module 2)
Liberal Studies
Physics
Chemistry
Biology (English)
Biology (Chinese)
Health Management and Social Care
Geography
Economics
History
Chinese History
Others: (Please specify)
Section IV. Other Educational Qualifications 其它教育資歷
Year
年份 / Name of Issuing Authority 頒發機構/
Subject 科目 / Grade
等級 / Year
年份 / Name of Issuing Authority
頒發機構/ Subject 科目 / Grade
等級
e.g. 2017 / IETLS/ English / 6.5
Section V. Professional Qualifications 專業資格
Qualification Awarded
所獲資格 / Name of Issuing Authority
機構名稱 / Document No.
編號 / Date Obtained/issue date (dd/mm/yyyy)
所獲/發簽日期
(日/月/年) / For office use
本欄母須填寫
e.g. Enrolled Nurse / Nursing Council of Hong Kong / ENG1234567 / 1/12/2015
e.g. BLS Provider / The American Heart Association / T5-2A1 / 15/11/2017
Section VI. Work Experiences (start with present or the most recent employment)工作經驗(由現在或最近僱主開始)
Name of Organisation
機構名稱 / Name of Service Unit
(Note 1)
服務單位名稱
( 註1) / Nature of Employment
(Note2)
工作性質(註2) / Position Held 職位 / Nature of post enrolment experience (e.g. medical/ surgical) (Note 3)
服務性質(註3) / Date (dd/mm/yyyy)
日期(日/月/年) / Duration of experience (months)
From
由 / To
至
e.g. St. Teresa’s Hospital / Ward 5A / 全職/ 兼職
Full-time/ Part-time / EN / Surgical / 15/12/2015 / present / 22 months
全職/ 兼職
Full-time/ Part-time
全職/ 兼職
Full-time/ Part-time
全職/ 兼職
Full-time/ Part-time
全職/ 兼職
Full-time/ Part-time
全職/ 兼職
Full-time/ Part-time
註1: 如曾經或正在福利機構工作,請註明服務單位名稱。Note 1: For an applicant previously / currently working in the welfare sector, please also indicate the name of the service unit.
註2: 請刪去不適用者。Note 2: Please delete as appropriate.
註3: 如適用,請註明。Note 3: Please provide details if applicable.
Remarks: You may provide information which you consider is relevant to your application. Please be concise and attach additional sheets if needed.
Other Information 其他資料1.Have you everbeen convicted ofacriminaloffenceinacourtoflaw? 閣下曾否因刑事案件而被法庭定罪？
Yes是□Reason原因
No否□
2.Doyou haveanyspecialeducationalneeds?閣下是否有特殊教育需要？
Yes是□Pleasedescribe 請詳述
No否□
Declaration 聲明
I declare that the information given in this application form is, to the best of my knowledge, true and correct. I understand and accept the condition that I will be disqualified for admitting to the Higher Diploma in General Nursing (Enrolled Nurses) Programme if it is proved by the School that I have knowingly given false information.
上述資料乃據實填報,若填報的資料失實,本人的入學資格將會被取消。
簽名
Signature: / 日期
Date:
For office use only (只供有關部門填寫)
Photocopies of document(s): / Photocopies of other documents: (please specify)
HKID / Yes/No
Certificates of educational qualifications in Section III / Yes/No
Certificates of other educational qualifications in Section IV / Yes/No
Certificates of professional qualifications in Section V / Yes/No
Application fee / Yes/No
Signature of Administrative Staff :