Application No. (for official use only)
THE HONG KONG UNIVERSITY OF SCIENCE AND TECHNOLOGY
APPLICATION FOR ADMISSION AS A
POSTGRADUATE VISITING INTERNSHIP STUDENT
1.
2.
3.
Please read the ‘Notes for Applicants’ carefully before filling-in this form.
This form should be completed in English. Applicants are recommended to complete the form in Microsoft Word, and print it for
signature. Alternatively, please type or print in black ink.
Please enclose all substantiating documents stipulated in the 'Notes for Applicants'. Please append additional sheets, if necessary.
Part 1 PERSONAL PARTICULARS
Name in English
Surname
Given Names
Name in Chinese (if applicable)
Date of Birth (dd/mm/yyyy)
Place of Birth (Country)
Gender
(Must be identical as it printed on
identity documents)
-- Select -Identification Number
H.K.I.D. Card Number (if applicable)
Other Identification No.
Issuing Country
(Please provide other ID no. if you
do not hold an H.K.I.D. card)
Travel Document
Passport No.
Passport Issuing Country
(if applicable)
Nationality/Citizenship
Hong Kong
(Please select one. See the Notes for
Applicants for codes)
People’s Republic of China ---
Others ---------------------------
Native Place Code (祖籍)
Residence Code (戶籍)
(See Note 10.iv.)
(See Note 10.iv.)
(please specify)
I do not need a Student Visa/Entry Permit to pursue studies in Hong Kong because:
Need for a Student Visa/
Entry Permit
(Please select one)
I have the right of abode in Hong Kong
(There is a letter “A” under the date of birth in my H.K.I.D. card).
I have the right to land in Hong Kong
(There is a letter “R” under the date of birth in my H.K.I.D. card).
I will use the following document to enter Hong Kong.
Please specify:
Valid till (dd/mm/yyyy):
I would need a Student Visa/Entry Permit to pursue studies in Hong Kong.
Correspondence Address
(Max 40 characters per line)
1:
2:
Country
3:
Contact Information
4:
Mobile Phone No.
Other Contact Phone No.
(Please include both country code
and area code)
Email Address
Previous Studies at HKUST
(Please select one)
I have previously studied at HKUST. My student number was
I have not studied at HKUST before.
Page 1
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Version: July 2015
Part 2 CURRENT PROGRAM OF STUDY
Please provide information on the program you are currently attending.
Level of Qualification
(e.g. Master’s degree)
Name of Institution
Country of Institution
Title of Award
(e.g. MSc in Molecular Biology)
Degree Major/Area of Study
(e.g. Biology)
Program Duration
Current Year of Study
years
(number of years)
(e.g. Year 2)
Program Commencement Date
Mode of Study
(mm/yyyy)
(full-time/part-time)
Expected Date of Completion/Graduation
(mm/yyyy)
Latest GPA/Average Mark
Part 3
Year
-- Select --
.
, highest attainable mark
ENGLISH LANGUAGE PROFICIENCY
Please select ONE of the followings:
English is my mother tongue.
English is not my mother tongue but my degree was awarded by an institution where the medium of instruction was English.
(A letter of certification issued by your home institution, if available, should be provided as proof.)
English is not my mother tongue, and I obtained the following English test result(s).
Examination
Date of Test
Candidate No.
(dd/mm/yyyy)
(6-digit)
Date of Test
Registration No.
(dd/mm/yyyy)
(16-digit)
Listening
Reading
Writing
Speaking
Overall
Band Score
Reading
Listening
Speaking
Writing
Total Score
IELTS
Examination
TOEFLInternet Based
Others, please specify:
Name of Test
Date of Test
Result
(dd/mm/yyyy)
None of the above.
Part 4 DEPARTMENT APPLIED FOR
Department
Proposed Period of Internship at HKUST
Supervisor
From (dd/mm/yyyy)
Page 2
To (dd/mm/yyyy)
Version: July 2015
Part 5 REASONS FOR APPLYING FOR ADMISSION AS A POSTGRADUATE VISITING INTERNSHIP STUDENT
Part 6 DOCUMENT CHECKLIST
(Please note that all documents submitted will NOT be returned)
Application Form
Institutional Support Form
Official transcript and testimonial of current study
Copies of the relevant course outlines that the applicant has completed and/or is currently enrolled on
Copy of proof of English Language proficiency, if any
Photocopy of the travel/identity document containing personal particulars
Application fee
Part 7 DECLARATION
1. I declare that the information given in support of this application is accurate and complete. I understand that this information will be used
in the admission decision process and that any misrepresentation will disqualify my application for admission and enrollment in HKUST.
2. I have obtained permission from my home institution to register with the HKUST as a Postgraduate Visiting Internship Student.
3. I authorize HKUST to obtain any and all information about my candidature for my studies in institutions in Hong Kong and elsewhere.
4. I authorize HKUST to use my data as a basis of all types of processing relevant to admission as a Postgraduate Visiting Internship Student
at HKUST and for all other associated purposes.
5. I understand that, upon my registration as a Postgraduate Visiting Internship Student, this data will become a part of my student record at
HKUST. That student record may be used for a number of academic and administrative purposes consistent with the mission of the
University, including academic advising, program planning and evaluation, etc.
Applicant’s Signature:
Date:
Page 3
Version: July 2015