Hong Kong Nang Yan College of Higher Education

From (mm/yyyy)

To (mm/yyyy)

School / College / Institution Attended / Attending

Programme Title

Full Time / Part Time

Level / Qualification Attained

Application Form *Must be filled

Programme applied for

1st Choice:

2nd Choice:

Part I : Personal Particulars

* Mandatory Field

Passport / HKID No.:

* HKID ( eg. A1234567 ) Passport

Issue Country:

( Others )

Surname:

* First Name: * Title: Mr. Miss Mrs. Ms. *
(Must be the same as ID Card)

Name in Chinese:

(Must be the same as ID Card)

Date of Birth:

/ / * ( dd / mm / yyyy )

Nationality:

( Others )

Mobile / Pager:

Home Tel.:

Office Tel.:

Fax No.:

E-mail Address:

Postal Address:

( Area )

Are you a permanent resident of the HKSAR ? Yes No *

Part II : Education Level

School / College / Institution Attended / Attending *

Please provide details of your secondary school and tertiary education, including incomplete and/or current studies, in date order, from the most recent studies.

Public Examination Qualifications

�]HKDSE, HKALE & HKCEE�^Please list all details below.

Examination	Year of Attempt (yyyy)	Subject Taken and Grade obtained
Hong Kong Diploma of Secondary Education		Subject: Grade:
		Subject: Grade:
		Subject: Grade:
		Subject: Grade:
		Subject: Grade:
		Subject: Grade:
		Subject: Grade:
		Subject: Grade:
Hong Kong Advanced Level		A-Level Subjects
		Subject: Grade:
		Subject: Grade:
		Subject: Grade:
		Subject: Grade:
		AS-Level Subjects
		Subject: Grade:
		Subject: Grade:
		Subject: Grade:
		Subject: Grade:
		Subject: Grade:
		Subject: Grade:
Hong Kong Certificate of Education		Subject: Grade:
		Subject: Grade:
		Subject: Grade:
		Subject: Grade:
		Subject: Grade:
		Subject: Grade:
		Subject: Grade:
		Subject: Grade:
Others (Please specify)

Professional Qualifications

�]e.g. qualifications obtained from the Associated Board of the Royal Schools of Music (ABRSM) or other recognised schools, musical instrument and musical theory examination, art training, professional qualifications, etc.�^

Year (yyyy)	Awarding Institution	Award (grade or class of membership)

Other Relevant Information

Please provide information which you feel will benefit your application here, e.g. extra-curricular activities, voluntary work, your strengths, career aspirations, etc.

Part III : Working Experience

Please list your work experience in date order, from the most recent job.

Name of Company	Position	Full Time / Part Time	From (mm/yyyy)	To (mm/yyyy)

How did you first learn of this programme?

Newspaper / Magazine	Which Newspaper / Magazine ?
Programme Brochure	Friends	Expo
College Website
Other website, e.g. Facebook :
Others (Please specify) :

Part IV : Refund

Once an applicant accepts an admission offer, they are required to settle a deposit payment (Bachelor Degree and Higher Diploma Programmes: $5,000, Diploma Programme: $3,000). Unless the programme is cancelled, all fees paid by the students will not be refunded no matter they have attended classes or not, except in the event as stated in No.2 below.

2.	Applicants of Bachelor Degree Programme who have accepted an offer of admission to a UGC-funded bachelor degree programme may apply for a refund of the deposit and first instalment of tuition fees paid.

3.	All fees paid will not be refunded after commencement of an enrolled programme.

4.	In principle, if students wish to withdraw from studies, all tuition fee paid will not be refunded. However, the President of the College has the right to give discretion in that regard. Only under special circumstances will such discretion be exercised.

Part V : Personal Data (Privacy) Ordinance

1.	The personal data you provided will be used for admission and registration purposes.

2.	Please ensure that the information provided here is accurate or complete. Otherwise, the College may not be able to provide you the required services.

3.	The College will keep your personal data in a secure manner, and the information could also be provided to relevant persons in the College or other persons or organisations providing services to the College.

4.	Under the Personal Data (Privacy) Ordinance, you have the right to inquire about or change your personal data.

5.	If you need to inquire about or change your personal data kept in the College, please send an email to registry@ny.edu.hk to provide the details to the staff of the College.

Declaration

1.	I declare that all information given in this application form is, to the best of my knowledge, accurate and complete.

2.	I have read the ��Personal Data (Privacy) Statement�� as detailed in Part V.

3.	I agree that if registered, I will conform to the Statutes and Regulations of the College for the time being in force.

Accept *