The Hong Kong University of Science and Technology
School of Humanities and Social Science
Application for International Student Exchange Programme (Exchange-in Students)
Notes:
Please complete all sections in English, and forward the completed form together with the following supporting documents to the
exchange programme coordinator at your home University (Hardcopy and original copy, print-out from scan version is not accepted);
1) Resume
2) Statement of Interest (with your name on each page)
3) Official academic transcript (with English translation if necessary)
4) Copy of the National Passport (showing your photo)
5) Copy of HK ID Card (if any)
6) Copy of official TOEFL or IELTS Certificate or other Proofs on you English Language Proficiency (if any)
7) Letter of recommendation from program advisor or equivalent (if any, in separate sheet of paper, DON’t use P.3 of this Form)
PART A – To be Completed by the Applicant
Proposed Period of Exchange:
 Fall
(please ‘tick’ one and write down the year)
(1)
 Spring
(Sep – Dec)
PERSONAL PARTICULARS
Name (as shown on your passport):
 Fall and Spring
(Feb – May)
(Sep – May)
(*delete as appropriate)
Surname
Given Name(s)
Country of Citizenship:
Hong Kong Identity Card No. (if any):
Gender:
Passport No.:
Passport Expiry Date:
Place of Birth:
Date of Birth:
Home
Email:
* Male / Female
(DD/MM/YY)
(DD/MM/YY)
______________________________
Address:
Name of Home University:
Major:
Address of Home University:
Year of Study in 2015/16 Academic Year:
Special Educational Needs (eg. disabilities, learning difficulties):
(2)
(Leave blank if there is none)
CONTACT INFORMATION
Please provide information that would allow us to contact your parents for emergency.
If there are any changes after submission, please inform us as soon as possible.
Parents / Guardian’s Name:
Relationship:
Address:
Phone:
(
)
Country Code
SHSS_Ex-in_Application Form
(
)
Email:
Area Code
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School of Humanities and Social Science
(3)
COURSES ENROLLED AT HOME UNIVERSITY IN THE CURRENT TERM
Course Title
(4)
Course Title
TENTATIVE COURSE SELECTION AT HKUST
Please refer to this website for more details https://w5.ab.ust.hk/wcq/cgi-bin/ . (Courses in the Course Catalog are for
reference only.
Not all courses in the Catalog are offered every term and will be confirmed before term starts.) Course enrollment is
subject to confirmed course offerings, seat availability, and satisfaction and/or approval of course pre-requisite
requirements. ** Please be reminded that for courses offered by School of Business and Management (SBM) are
usually restricted only for SBM students. Students from other schools cannot enroll in those courses (e.g. MGMT,
GBUS courses)
Priority
Course Code
No. of Credits
Priority
1
5
2
6
3
7
4
8
Course Code
No. of Credits
Total No. of Credits:
(5)
STATEMENT OF INTEREST
For Undergraduate Students: On a separate sheet of paper, in English, briefly describe (within 300 words) why you
wish to participate in the exchange programme at HKUST and what you are planning to achieve from this overseas
exchange experience.
For Postgraduate Students: On a separate sheet of paper, in English, to describe (within 500 words) your research
interest and proposed subject of research/study.
(6)
DECLRATION
I am applying for the International Student Exchange Programme to The School of Humanities and Social Science
(“SHSS”), The Hong Kong University of Science and Technology (“HKUST”) and declare that the information
provided is accurate and complete. I understand that provision of any false and/or misleading information shall
lead to disqualification of my application and cancellation of my resulting registration. I also authorize SHSS,
HKUST and the relevant authority to obtain and release any and all information about my candidature for public
examinations and my studies in institutions in Hong Kong and elsewhere if necessary. By signing this application, I
am giving my consent to HKUST to release my academic records at HKUST to my home university that appears in
Part B below. With my consent, SHSS may use my contact details, demographic details, exchange-out information
and share among other offices or other exchange students in HKUST for promoting of exchange activities and other
related collaboration .
Applicant’s Signature:
SHSS_Ex-in_Application Form
Date:
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School of Humanities and Social Science
PART B – To be Completed by the Exchange Programme Coordinator of your Home University
I recommend / do not recommend this applicant for the International Student Exchange Programme at The School of
Humanities and Social Science, The Hong Kong University of Science and Technology.
Recommendation:
Name:
University:
Department:
Post Title:
Date:
Signature:
Official Chop:
SHSS_Ex-in_Application Form
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School of Humanities and Social Science