Scholarship for Short-Term Vocational Training Courses Application ...

Po Leung Kuk/Henrik Nielsen/Foreign Correspondents’ Club Scholarship FundScholarship for Short-Term Vocational Training Course2013- 2014* Delete whichever is inapplicableA) PERSONAL PARTICULARS(For Discharged Residential Children)1. Name in full *Mr. / Miss: ___________________________ _______________ _____________(as on Identity Card and in Block Capitals) (English Name) (Chinese)2. Place of Birth: ____________________________________________________________________3. Date of Birth: _______YY_______MM_______DD4. Length of Residence in Hong Kong: __________ years (from _____ to _____)5. *Nationality/ Citizenship: ___________________________________________________________6. Hong Kong Identity Card Number: ____________________________________________________7. Correspondence Address: (in Block Capitals)________________________________________________________________________________________________________________________________________________________________8. Home Telephone No.: _______________ Day-time Contact Telephone No.: _________________9. Email Address: ____________________________________________________________________10. Name of School and Class (20__/20__) ________________________________________________11. Period Living in Po Leung Kuk Residential Child Care UnitFrom ____YY ____MM to____YY ____MMSection: *Babies Section / Kinder Section / New Comers’ Ward / Emergency Foster Care /Children Section / Small Group Home (Please specify ____________)A recentphotograph ofthe applicant tobe affixed hereB) INFORMATION ON THE SHORT-TERM COURSE UNDER APPLICATION(Please submit supporting documents)1. Course Title: ______________________________________________________________________2. Name of the Institution/ Organization Offering the above Course: _____________________________________________________________________________________________________________3. Expected Date of Commencement of the Course: _________________________________________4. Expected Date of Completion: ________________________________________________________5. Course Fees: HK$___________________C) OTHER INFORMATIONHow your proposed study course related to your career interests and future occupation? (Use separatesheets if necessary)____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Page 1

DECLARATION BY APPLICANTI, _________________________ (name), declare that the statements made in this application are, to thebest of my belief, true, complete and correct. I have read and fully understand the Information Notegiving details of the scholarship which I am now applying for.Signature: _________________________________Date: ________________________RECOMMENDATION (to be completed by social workers)Name: Dr. / Mr. / Ms.*__________________________________________________________________Name of Residential Unit: _______________________________________________________________Position: _____________________________________________________________________________Telephone No.: ________________________________________________________________________Recommendations: (Use separate sheets if necessary)_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Signature: _________________________________Date: ________________________Page 2

Personal Information Collection StatementThe personal data provided in the application forms for Po Leung Kuk/Henrik Nielsen/Foreign Correspondents’ ClubScholarship Fund will be used for scholarship application and other scholarship-related purposes. It may be provided to PoLeung Kuk Education Affairs Department (EAD) and other organisations or agencies authorised to process the information forpurposes relating to scholarship released by Po Leung Kuk e.g. income assessment, academic achievement andconditional/straight offer by any Universities/Tertiary education provider, etc. as may be necessary.Your provision of all the personal data requested in the application forms for this scholarship is obligatory, except thoseitems clearly marked as optional. Your application will not be considered if you fail to provide all information as requested orit is not clear from your statements that you have met the requirements specified for the scholarship.You are required to notify Po Leung Kuk EAD if there are any subsequent changes to the information provided aftersubmission of the application form. Information on unsuccessful candidates will normally be destroyed 24 months afterrejection of the candidate's application.For correction of or access to personal data after submission of the application form or enquiries on the scholarship matters,please contact the subject officer of EAD as specified in the application memo.Page 3