FOR OFFICE USE
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Session
THE HONG KONG INSTITUTE OF EDUCATION
The 16th Congregation
COMPLETED FORM (IN
ENGLISH OR CHINESE)
MUST
BE PRODUCED FOR
COLLECTION OF GOWN
Form on Loan of Graduation Gown
*Please read the Information Notes to Graduates carefully before completing this form.
Personal Details
Name:
(English)
Student No.:
Programme code:
(Chinese)
(please check the code on your Student ID Card)
Programme title:
Contact Telephone No. (Day):
Collection of Graduation Gown (please √ one of the boxes below)
□
Collect in person
□
Collect by authorized person
I, ________________________________________ (Student No: ____________________________) would like to authorize
Mr/Ms _________________________________________ (HKID Card No: _______________) to collect a set of academic
gown and admission tickets on my behalf.
□
Collect by self-courier service
I, ________________________________________ (Student No: ____________________________) would like to authorize
____________________________________________________ (Name of Self-Courier Service) to collect a set of academic
gown and admission tickets on my behalf. My contact telephone number is ________________. (You should write the name
of the self-courier service clearly. The Institute may contact you in advance to confirm the details of the company).
Size Requested (2nd choice will be given if items are out of stock)
Gown:
Cap:
L
L
 XL
 XL
Not applicable for sub-degree programmes
1st choice:
 XS  S
M L
2nd choice:
 XS  S
M L
 XL
 XL
1st choice:
2nd choice:
 XS
 XS
S
S
M
M
Reference for Size Fitting (subject to minor variation)
XS
S
M
L
XL
Size of Gown
to fit height
5’1” or below
5’2” – 5’4”
5’5” – 5’8”
5’9” – 6’
over 6’
Size of cap
to fit head rim
21”
21.5” – 22”
22.25” – 22.5”
23”
over 23”
Declaration
I accept and abide by the regulations below:
i) A penalty charge is to be levied in case of late return or any damage/loss of the graduation gown. I have read the schedule of
penalty charge below.
ii) The Institute reserves the right to withhold issuing any academic documents to me if I fail to settle any outstanding liabilities.
Graduate’s signature:
Date:
Penalty Charges for Late Return/Damage/Loss of Graduation Gown
 Penalty for late return: HK$30 per working day (counting from 13 December 2010 , Saturday is not counted as one working day)
 Penalty for any damage/loss:
MEd/MA/PGDE/PDES/BEd/BA
: Gown – HK$400
Hood* – HK$150
Cap – HK$150
CE
: Gown – HK$350
Hood – HK$100
* For degree and master’s degree graduates.
Please settle the penalty charges in advance at any Bank of East Asia branch. Payment by cash at the Lecture Theater C-LP-11 will
NOT be accepted. You can pay the penalty by direct deposit or ATM transfer to the account: 015-195-25-00100-0 of the Bank of
East Asia. Please write down your name, student number and programme code at the back of the receipt for verification purpose.