Applicants can choose a maximum of 2 choices from the following programmes. (Programme Choice 1 as your first choice and Programme Choice 2 as your second choice.)

申请人可填选最多两个课程。(课程选择1为首选,课程选择2为次选。)

Programme Choice 1 课程选择 1:
Programme Choice 2 课程选择 2:

* Please read “Information for Mainland Applicants” before you fill in this form.
* 在填写这申请表格之前,请先阅读《内地学生入学须知》。
NOTE:
请注意:
(1)
Please contact PolyU HKCC directly for enquiries and application procedures. PolyU HKCC does not cooperate with any organisations on the Chinese mainland on admission activities.
所有入学申请和查询,请直接与香港理工大学香港专上学院联络办理。学院未与国内任何机构合作宣传或招生。
(2)
All visa application from Mainland applicants should be submitted to Immigration Department via the College (sponsor).
内地申请人的签证申请,必须经由院校(保证人)向入境事务处递交。
(3)
The College will only handle the first submission of your application form if you have submitted more than once. If you wish to update the information, please contact us by email (ccadmission@hkcc-polyu.edu.hk).
如你重复提交申请,学院只会以你第一次提交的申请作准。如欲更新申请资料,请以电邮(ccadmission@hkcc-polyu.edu.hk)通知本校。
(4)
Please submit Form 33-M to us via email (ccadmission@hkcc-polyu.edu.hk) if you wish to submit request on change of programme choices. The deadline for submitting request is 24 June 2018. Please note that you are allowed to submit the request ONCE.
如你希望更改你的课程选择,请以电邮(ccadmission@hkcc-polyu.edu.hk)提交表格33-M至本校。更改课程选择的截止日期为2018年6月24日。请留意,你只可提交一次更改课程选择的申请。
(5)
Please fill in the information below. Fields marked with an asterisk (*) denote mandatory fields.
请填写以下资料。附有(*)号的项目必须填写。
(*)1. Full name in English (as shown on your Exit-Entry Permit for Travelling to and from Hong Kong and Macau or Passport)
英文姓名拼音(请依你的中华人民共和国往来港澳通行证或护照输入)
Surname 姓
Given name 名
(*) 2. Full name in Chinese (as shown on your Mainland ID Card)
中文全名 (请依你的中国居民身份证输入)
(*) 3. Gender 性别
Male 男
Female 女
(*) 4. Date of Birth 出生日期 (YYYYMMDD)(年月日)
Please input 19980102 if your date of birth is 2 Jan 1998. 如你的出生日期为1998年1月2日,请输入 19980102。

(*) 5. Mainland ID Card Number 中国居民身份证号码
(*) 6. Correspondence Address in Chinese 中文通讯地址


(*) 7. Province 居住省份
(*) 8. Postal Code 邮政编码
9. Telephone Number 联络电话
(*) 10. Mobile Number 手提电话
(*) 11. Email Address 电邮地址 (Email is the major way of making contact with you, please make sure the email address is valid.) (电邮为学院与你联络的主要途径,请确保电邮地址正确。)
(*) 12a. Academic Attainment (1): Highest Qualification Attained
学历(1):所达到的最高程度


(*) 12b. Academic Attainment (2): Secondary Education
学历(2):高中学历

From 由 Month 月 Year 年
To 至 Month 月 Year 年
Schools Attended / Attending 曾经/现在就读的学校

Class Attended / Attending 曾经/现在就读年级

13. Supplementary Information 附加资料
Provide further details relevant to your application, such as work experience (for mature applicants) and outstanding achievements in athletic, artistic, social services or other cultural activities, and submit supporting documents (e.g. award certificates)
提交其他与本申请有关的资料,如工作经验(适用于「年长生」)、体育、体艺、社会服务或其他文化活动方面的杰出成就等,并递交证明文件(如奖状)。

14. Applicants with Disabilities 伤健申请人
It is the College’s policy to offer equal opportunities and suitable services and support to all applicants. If you have a disability, please specify the condition.
学院致力提供平等机会予所有申请人,并尽力切合不同需求。申请人若为伤健人士,请简述有关情况。

Are you an applicant with disability? 你是否伤健申请人?
Yes 是 No 否
If “yes”, please specify the condition. 若为伤健人士,请简述情况。

If “Others” is chosen in the question above, please specify. 若于以上伤健类别选择「其他」,请注明状况。
(*) 15a. Authorisation and Declaration(1) 授权及声明(1)
I authorise Hong Kong Community College (HKCC) to use my personal data, including my name, contact phone numbers, email and correspondence address, for the following purposes:
本人授权香港专上学院(下称「HKCC」)使用本人的个人资料,包括姓名、联络电话号码、电邮及通讯地址作以下用途:
  • For all types of processing relevant to my application for 2018/19 admission to HKCC and all other associated purposes, including identifying multiple applications / registration, and checking records of my studies as a student in institutions on the Chinese mainland and elsewhere;
    处理本人的2018/19 年度HKCC入学申请及相关用途,包括查核重复申请及注册,以及查阅本人于内地及其他地方之学生记录;
  • For HKCC, and the relevant authorities, to retrieve, release and have access to my results of any public examinations and my studies and / or qualifications;
    让HKCC及其他相关机构,检索及查阅本人的公开考试成绩、学历及/或资格;
  • For HKCC to transfer these data to the student record system upon my registration at HKCC. The data together with my photo image (collected at the time of registration) may be used for all purposes relating to my studies and student activities in the College and alumni affairs after my graduation;
    完成入学注册后,有关资料将转为学生记录。在学期间,HKCC可利用本人的学生记录,包括于注册时收集的学生照片,作任何与学习及学生活动相关的用途。毕业后,有关记录将用作校友会事宜;
  • For statistical and research purposes, with the understanding that my name and other personal details will not be disclosed.
    作统计及研究用途,唯本人的姓名及其他个人资料必须保密。
  • I understand that if my application is unsuccessful, HKCC will dispose of my application form and other related information by the end of December 2018, unless I tick the “agree” box below — in which case, my data will be retained by HKCC for direct marketing purposes, including distribution of promotional materials about programme information, admission news, and activities relating to College of Professional and Continuing Education (CPCE) and its educational units of HKCC and School of Professional Education and Executive Development (SPEED), as well as other PolyU faculties and departments.
    本人明白,假如本人的入学申请不成功,HKCC会于2018年12月底前销毁本人的申请表及相关资料。除非本人于以下的选项选择「同意」,HKCC方可保留本人的资料作寄发宣传信息用途。宣传信息包括:专业及持续教育学院及旗下教学单位包括HKCC及专业进修学院,以及理大学系/部门的课程资料、招生事宜及活动等。
Please choose the appropriate option below: 请选择下列适当选项:
I agree / do not agree to receive direct marketing information from HKCC.
本人 同意 / 不同意 收取HKCC寄发的宣传信息。
According to the Personal Data (Privacy) Ordinance, I have the right to request access to, and correct my personal data. Should I wish to do so, I need to submit my request(s) in writing to HKCC.
根据个人资料(私隐)条例,本人有权查阅及更改个人资料。如有此需要,本人会以书面形式通知HKCC。
For “Personal Information Collection Statement” and “Privacy Statement” of HKCC, please visit www.hkcc-polyu.edu.hk/admission/PICS.pdf.
有关HKCC的「收集个人资料声明」及「私隐政策声明」,请浏览 www.hkcc-polyu.edu.hk/admission/PICS.pdf
(*) 15b. Authorisation and Declaration(2) 授权及声明(2)
I hereby understand and agree that admission to any undergraduate degree programmes offered by universities in Hong Kong after my successful completion of an Associate Degree programme with HKCC will be based on my academic achievement in HKCC and personal merits. All universities in Hong Kong have full discretion to admit students based on their own criteria and admission procedures, therefore HKCC does not guarantee my admission to any undergraduate degree programmes offered by local universities . I also understand that as stipulated by the University Grants Committee (UGC) of Hong Kong, non-local sub-degree graduates shall not be considered for UGC-funded senior year places in UGC-funded institutions. However, non-local sub-degree graduates may apply for admission into the first year of an undergraduate degree programme and / or apply for credit transfer in these institutions.
本人明白在完成HKCC的副学士课程后,我需以本人的学业成绩和能力申请香港各大学开办的学士学位课程。由于香港各大学取录本科学生均有其特定的准则及程序,HKCC不能保证本人可成功于本地升读学士学位课程。本人亦明白,根据香港大学教育资助委员会(教资会)规定,教资会资助院校不会考虑副学位课程的非本地毕业生,申请报读其教资会资助的高年级学士学位课程;然而,副学位课程的非本地毕业生仍可申请这些院校的一年级学士学位课程,或以既有学历申请豁免部分学分。
I understand that it is my own responsibility to ensure my eligibility of abode in Hong Kong or obtain a valid study visa from the Immigration Department of the HKSAR Government before the commencement of study (1 September 2018) and I will bear all losses caused by failure to ensure the above-mentioned eligibility.
本人明白必须于2018年9月1日开课前取得香港居留权,或持有香港入境事务处签发的有效学生签证,并对因居留/入境签证问题而导致的任何损失负全责。
Please tick the box below: 请在下列空格内加上剔号:
I have read and understood all the details above and in the “Information for Mainland Applicants” and will comply with all the stated rules and regulations. I declare that the information given in support of this application is accurate and complete. Any false or misleading information will lead to disqualification of my application and nullification of any registration. All fees paid will not be refunded.
本人已详阅及明白以上声明及《内地学生入学须知》的内容,并会遵守当中所列的守则和规定。本人声明,本表格内填报的资料均属真实无讹。如提供虚假或误导资料,申请及注册资格会被取消,已缴费用一概不获退还。
16. How did you learn about HKCC’s programmes? (You may tick more than one box.)
你如何得悉學院之課程?(可选多于一项)
  • Website Advertisements 互联网广告
  • Web Discussion Forums – Please specify which forum(s) 互联网讨论区,请注明
  • Newspaper Advertisements – Please specify which newspaper 报章广告,请注明
  • Coverage in Publications – Please specify which publication 刊物的介绍,请注明
  • Bus Advertisements 巴士广告
  • MTR Advertisements 港铁广告
  • Radio 电台
  • HKCC Guide to Enrolment 学院申请入学手册
  • HKCC Programme Leaflets 学院课程单张
  • HKCC Website 学院网页
  • Referral by Relatives / Friends 亲友推介
  • Referral by Schoolmates 同学推介
  • Referral by Teachers / School 师长/学校推介
  • Others – Please specify 其他,请注明

Please double-check that your input is correct before clicking the “Submit” button. Once you have submitted the form, no amendment could be made through this online form.
按「提交」前,请再查阅所输入的资料是否正确无误。已提交的资料将不能于此网上表格更改。