Academic / Non-academic Units Activity with ILP Units Student Completion Record* 1. Name of Activity: ________________________________________________ (In English) 2. Particulars of Applicant: Name of Academic / Non-academic Unit: _______________________________________________________________ (In English) Name of Staff in Charge: ___________________________________________ (In English) Approved ILP Domain Approved ILP Unit(s) (please tick one box ONLY) (No more than 6 ILP units will be granted to each participant in one activity) □ Civic Education □ Intellectual Development □ Physical Education □ Social & Emotional Development □ Aesthetic Development Student Name (In English) Student ID No. _________________________ Staff in Charge _________________ Date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Signature: * Please submit this Student Completion Record to Student Services Centre (within ONE month after the completion of the activity). SSC / Academic Department / Administrative Unit Activity with ILP Units – Student Completion Record Page 1 of 1