The Hong Kong University of Science & Technology - seng, hkust

The Hong Kong University of Science & Technology
Student Housing Office
Application for On-campus Accommodation 2012 / 2013
(Exchange-in Undergraduate Students – Spring Term)
Serial No: ______________
Residential Period: 25 January 2013 to 3 June 2013, both nights inclusive
The information obtained will be used for the admission exercise for on-campus residence 2012 / 2013, and
will also be kept as resident / applicant records for administrative purposes.
Please read the following instructions carefully before completing this application:
1. This form MUST be completed in ENGLISH and in BLOCK LETTERS.
2. Completed application form should be returned to the Student Housing Office on G/F of UG Hall II either by
fax (852) 2719 5455 or by email to shoug@ust.hk .
3. Each applicant is allowed to submit only ONE application; applicant found submitting more than one
application will be disqualified without notice.
4. Deadline of application: 30 November 2012
5. Unless with the certification of the school of study here at HKUST that the applicant’s exchange program will be
extended beyond 3 June 2013; otherwise, all exchange students are required to check out of the student halls
before 1200 noon on 4 June 2013. Applicant should take this into account when planning your flight home
or arrange other sources of accommodation on your own if you are going to stay in Hong Kong after the
above-mentioned date.
6. If you apply for Hall VII iVillage LLC residence, you MUST complete Section F or else your application for
Hall VII residence will NOT be considered.
By signing hereunder, I certify that the data provided in this application form are accurate and complete. I understand
that provision of false information may lead to disqualification of the application and possible disciplinary action.
Signature:
Date:
Section A:
Personal Information
Name in English: _____________________ , ___________________ Name in Chinese: _______________
(in BLOCK letters) (surname) (first name) (if applicable)
Country of Citizenship: _______________ Program of Study (if any): ________________ Gender: _______
Section B:
Address
Home Address (All correspondences will be directed to this address unless otherwise specified):
______________________________________________________________________________________
___________________________________________________________ Country: ___________________
Correspondence Address (if different from above): _____________________________________________
______________________________________________________________________________________
Phone No.: _________________ E-mail (for result notification):_________________________________
ExIn-App-SS13

Section C:
Academic Information
Name of Home Institution: _________________________________________________________________
Year of Study at Home Institution in the 2012 / 2013 Academic Year:
Year 1 (Freshman) Year 2 (Sophomore) Year 3 (Junior) Year 4 (Senior)
I will be participating in an exchange program to HKUST for the Spring Term 2013 organized by the School
of:
School of Business & Management
School of Science
School of Engineering
School of Humanities and Social Science
Section D:
Preference of Room Type and Roommate (Please “” whichever appropriate)
Preference of Room Type (please select one only):
Double room (HKD$6,175 for Spring 2013)
Bunk-bed room (HKD$5,129 for Spring 2013)
Triple room (HKD$4,627for Spring 2013)
Double room in Hall VII (HKD$7,729 for Spring 2013)
Preference of Roommate (please select one only):
I prefer to stay with a local student
I prefer to stay with a non-local student, including student from Mainland China
I prefer to stay with another exchange-in student
I prefer to stay with _____________________________________________ who is also an exchangein
student in the Spring Term 2013
I do not have any preference for a roommate
Section E: Other information you wish HKUST to note in arranging on-campus accommodation, if
any.
ExIn-App-SS13

Section F:
Living Learning Communities (LLC) Application
The University believes that the halls should offer diverse residential life experiences. To facilitate the
learning and development of its residents in a holistic manner, the Living Learning Communities (LLC)
Program was launched in Spring Term 2009. In the Spring Term 2013, iVillage Living Learning
Community will offer bed spaces for exchange-in students.
For information on LLC: http://llc.ust.hk/
If you have any question regarding the LLC Program and the iVillage LLC, please contact the LLC Coordinator
at (852) 2358 5797 or email to ivillage@ust.hk
______________________________________________________________________________________
- Applicants for Hall VII iVillage LLC MUST complete this section or else your application will not be
considered.
- Please submit your resume (no more than 1 page) in a separate .pdf format.
- Your application will be assessed by the iVillage LLC Admission Panel.
Please write the answers of all questions in no more than a total of 200 words in the spaces provided.
1. Tell us about recent experiences you have had with cultures other than your own and what have you
learned If you haven't, what would you hope to gain
2. What expectations do you have for your iVillage experience
3. What contributions can you make to the iVillage community
Pledge (Please “” the boxes below to show your acknowledgement of the conditions listed)
I understand that by completing Section F, I am requesting to reside in the iVillage LLC for the Spring Term 2013.
I understand that if selected for the iVillage LLC, I will be required to reside in a room designated and change of
room is not permitted unless with the authorization of the Residence Master.
I understand that I am expected to be an active participant in programs and activities organized by the community.
I understand that if I do not meet the expectations of the community or if I do not follow the rules of conduct of
the community, my residence in UG Hall VII may be terminated and I will not be assigned to reside in other
student halls for the rest of the residential year.
September 2013
SHO
ExIn-App-SS13