課程申請表

Course Application Form

課程選擇 Selection of Programme/Course
課程編號
Programme/Course Code
課程類別
Programme/Course Category
課程名稱
Programme/Course Name
開課日期
Commencement Date
高級文憑/毅進文憑核心課程上課地點
Venue of Higher Diploma/Diploma Yi Jin Core Subjects
N/A
毅進文憑 Diploma Yi Jin
---
N/A
沒有上課地點

本書院保留按需要更改原定課程細則:如上課時間、地點、任教導師等的權利。本書院也保留取錄學員與否並取消有關課程的最終權利,學員對此不得有任何異議;如有任何爭議,本書院將有最終決定權。
The Institute reserves the right to make alterations regarding the time, place, instructor and content of courses offered when necessary. The Institute also reserves the right to admit a student or not and to cancel a programme. In any cases, the Institute holds the final decision.

* 須與香港身份證相符 as shown in your HKID card
* 英文姓名
English Name
,


* 中文姓名
Chinese Name:

* 性別
Sex:

* 現持有之身分證明文件Identity Document:


* 香港身份證號碼
HK Identity Card No.
( )
 
* 出生日期
Date of Birth(DD/MM/YY)
(年/月/日)
# 出生地點
Place of Birth

# 國籍
Nationality

# 職業
Occupation

# 宗教
Religion


# 通訊地址
Correspondence Address



# 住宅電話
Home Phone No.

# 手提電話
Mobile Phone No.

# 電郵地址
Email Address
 
# 必須填寫 must fill in
 

家長/監護人資料 Particulars of Parent/Guardian
(21歲以下申請人必須填寫此部Applicant aged below 21 must complete this section)


家長/監護人英文姓名
Name of Parent/Guardian in English:
家長/監護人中文姓名
Name of Parent/Guardian in Chinese:
與申請人關係
Relationship to Applicant:
聯絡電話
Contact Phone No.:
 

緊急聯絡人Contact Person (in case of an emergency)

英文姓名 #
English Name:
中文姓名 #
Chinese Name:
與申請人關係 #
Relationship to Applicant:
聯絡電話 #
Contact Phone No.:
# 必須填寫 must fill in
 

學歷 Academic Qualifications
(只適用於設有入學要求的課程 For programmes that have admission requirements only)


最近就讀之院校
Name of Last Institute Attended
完成級別
Level Completed
曾參與公開考試
Public Examination Attended
就讀年份
Year of Study
自From 年YY 月MM    至 To 年YY 月MM
香港中學文憑考試
HKDSE:
5科最高成績總分 Total Score of Best 5 Subjects
類別 Categories 科目 Subjects 年份 Year 等級 Grade
1.
高中科目
中國語文 Chinese Language
2018
-
2.
高中科目
英國語文 English Language
2018
-
3.
高中科目
數學 Mathematics
2018
-
4.
高中科目
通識 Liberal Studies
2018
-
5.
高中科目
-
2018
-
6.
高中科目
-
2018
-
7.
高中科目
-
2018
-
8.
高中科目
-
2018
-
中學文憑試等級比對分數:
第1級 = 1, 第2級 = 2, 第3級 = 3, 第4級 = 4,
第5級 = 5, 第5*級 = 6, 第5**級 = 7
高中應用學習課程: 達標 = 2, 達標並表現優異I = 3,
達標並表現優異II = 4
HKDSE Common Scoring System:
Level 1 = 1, Level 2 = 2, Level 3 = 3, Level 4 = 4,
Level 5 = 5, Level 5* = 6, Level 5** = 7
For the ApL courses, Attained = 2, Attained with Distinction (I)
= 3, Attained with Distinction (II) = 4
中學會考/其他公開考試
HKCEE/Other Public Examinations:
中學會考/公開考試
HKCEE/Public Examination
年份 Year 科目 Subjects 程度 Level 等級 Grade
1.
2.
3.
4.

傷健或有特別學習需要人士 Disabilities or Special Educational Needs (自由選擇塡報 Optional item to fill)

你是否傷健或有特別學習需要人士? Are you a person with disability/(ies) or special educational need/(s)?
若是,請註明有關性質及程度。If yes, please indicate the nature and degree of disability/(ies) or special educational need/(s).
本書院以劃一準則考慮所有入學申請。在此欄填報的資料,有助本書院衡量提供設施協助同學學習。
All applicants will be considered on an equal basis. The collection of information about the nature and degree of any disability/(ies) or special educational need/(s) will be used by the institute to assess the provision of facilities to assist students in their studies.

其他資料
Other Information


閣下如何得知本書院課程資料
From what source(s) did you learn of CICE programmes:

聲明 Declaration

  1. 1. 個人資料收集聲明 Personal Data Collection Statement
    I、 閣下於申請表上所提供之個人資料將供本服務職員處理報名、註冊入學及學生事務之用。
    The personal data provided in this form will be used by Caritas Institute of Community Education (CICE) for purposes related to the processing of application, enrolment and student administration.
    II、 本服務亦會使用申請表上所提供之個人資料向閣下發放本服務的資訊,包括即將舉辦之活動、開辦之課程、各項優惠及服務等。 只有香港明愛之職員才會處理有關之個人資料, 所有個人資料均不會轉交香港明愛以外的第三者使用。
    The personal data provided in this form will also be used for delivering information including any events and functions to be held, courses/programmes to be organized, benefit and service offers etc. The personal data will be handled by Caritas – Hong Kong staff only and will not be transferred to other external parties outside the Caritas - Hong Kong.
    III、 根據個人資料(私隱)條例,申請人有權要求查閱及更正其個人資料。請申請人以書面提出有關之要求。
    Under the provision of the Personal Data (Privacy) Ordinance, applicants have rights to request access to and correction of their personal data. Applicants wishing to amend their personal data should submit written requests to CICE.
    IV、 若閣下不希望接收(乙)部所述的資訊,請於以下空格內加上剔號,或在日後透過本服務的網頁選擇停止接收該等資訊。
    If you do not wish to receive information as stated in (ii) of this statement, please indicate your objection by ticking the box below. You may unsubscribe from our mailing list through our website at any time.
      請不要向本人發送明愛社區書院的消息或宣傳資訊 Please do not send me news or marketing information of CICE.
  2. 2. 申請人聲明
    I、 本人謹此聲明在申請表內提供的資料均屬正確及完整。
    I declare that the information provided in this form is accurate and complete.
    II、 本人明白若提供任何虛假或誤導性資料,本人的申請資格及學位將被取消,而一切已繳交之費用概不退還。
    I understand that provision of any false or misleading information therein shall lead to disqualification of my application for admission and any resulting enrolment. Any fees paid will not be refunded.
    III、 本人如獲取錄入學,本人當遵守明愛社區書院所有適用的守則及規例。
    I agree to comply with all the Rules and Regulations for students as stipulated by CICE if my application is successful.
    IV、 本人已細閱、明白並同意以上之「個人資料收集聲明」及其他申請須知的內容。
 
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