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The Chinese University of Hong Kong: Application For Leave of Absence

1) The document is an application for leave of absence from The Chinese University of Hong Kong. 2) For medical leave exceeding one week, full-time undergraduates must submit a certificate signed by the Director of University Health Services, while part-time students must submit a certificate from a registered medical practitioner. 3) For non-medical leave exceeding one week, students must state the reasons for leave and submit supporting documents.

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44 views

The Chinese University of Hong Kong: Application For Leave of Absence

1) The document is an application for leave of absence from The Chinese University of Hong Kong. 2) For medical leave exceeding one week, full-time undergraduates must submit a certificate signed by the Director of University Health Services, while part-time students must submit a certificate from a registered medical practitioner. 3) For non-medical leave exceeding one week, students must state the reasons for leave and submit supporting documents.

Uploaded by

ADO_BE
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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THE CHINESE UNIVERSITY OF HONG KONG

Registration & Examinations Section


APPLICATION FOR LEAVE OF ABSENCE
()
MEDICAL LEAVE

In case of illness necessitating absence exceeding one week, full-time undergraduates should submit a medical certificate signed by the
Director of the University Health Service; part-time undergraduates should submit a certificate signed by a registered medical practitioner.
()
NON-MEDICAL LEAVE

A student who wishes to obtain leave of absence exceeding one week for non-medical reasons shall state the reasons for which leave of
absence is sought and submit all necessary supporting documents.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

in Chinese

Name :in English


/

Major / Programme :

(Programme Code:

Student I.D. No. :


Old Curriculum
New Curriculum

Year of Attendance:

Expected Year/Term of Graduation:

Contact Tel. No.:

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Leave applied :

From

to

()
Reason(s) (Please attach all necessary supporting documents) :


Signature :

Date :

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

1.
2.
3.

(3943 98882603 [email protected])

Personal Information Collection Statement


1.

The personal data provided on this form will be used by the Registration & Examinations Section for the purpose of processing this application.
All information provided, when no longer required, will be destroyed.

2.

Information provided on this form may be transferred to other departments/ administrative units within CUHK for consideration and granting

3.

For correction of or access to the personal data after submission of this form, please contact the Registration & Examinations Section:
(Tel. No.: 3943 9888, Fax No.: 2603 5129, e-mail address: [email protected])

approval, where applicable.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Endorsement by Major Department/Programme


I *endorse / do not endorse the student's application.

Signature of Dept. Chairman/Programme Co-ordinator

Date

* Please delete as appropriate


su/03/jh/Aug2012

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