CUHK



The Chinese University of Hong Kong

Faculty of Engineering

Professor Charles K. Kao Research Exchange Scholarships

Application Form for Summer Research Exchange 2020

Please submit the completed application to Ms. Stella Ng at stellang@cuhk.edu.hk by

20 November 2019.

(The personal data provided on this form will be used by CUHK and other relevant parties for selecting outgoing exchange students and related matters. Information on unsuccessful candidates will be destroyed after the recruitment exercise when it is no longer required.)

Section 1 - PERSONAL DATA

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|Name: (English as printed | | | |

|on HKID Card) | |(Chinese) | |

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|Sex: | |Age: | |Place & Date of Birth: | |

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|Nationality: | |College: | |Year: | |CU ID#: | |

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|Current Major: | |Current Minor, if any: | |

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|Degree Level* : ( Undergraduate (Please specify whether you are a final year student: Yes / No * ) |

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|Permanent Address: | |

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|Tel: (Home) | |Mobile: | |

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|Mailing Address: | |

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|Email address: | |

* Please check/delete as inappropriate.

Section 2 - EDUCATIONAL BACKGROUND

Please list below, in chronological order, secondary and post-secondary schools that you have attended.

|Name of Institution |Dates attended |Certificate, Degree or Diploma|Date Received |

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Section 3 - ACADEMIC PERFORMANCE

(a) Please fill in the Grade Point Average (GPA) for your undergraduate study at CUHK.

| 1st year | | 2nd year | | 3rd year | |

| Cumulative GPA | |

(b) TOEFL / IELTS SCORE

1. Have you taken TOEFL / IELTS*?

Yes, I have taken TOEFL / IELTS*. (Please answer Q.2) No

2. When did you take the test and what was your TOEFL / IELTS* score?

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Section 4 - HONOURS & PRIZES

Please list the academic awards (including prizes & scholarships) you have obtained, if any, in chronological order.

|Awarded By |Name of Award |Amount(HK$) |Year |

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Section 5 - RESEARCH-RELATED EXPERIENCE

Please state below any of your research-related experience, if any, in chronological order.

|Name of Company / Organization |Position, Job Duties, and Research Information |Period |

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Section 6 - EXTRA-CURRICULAR ACTIVITIES & EMPLOYMENT

Please list below significant activities in which you have participated (e.g. posts held in the Student Union, publications, athletics team, etc.) and your working experience, if any.

|Name of Association |Activities and Positions |Period |

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Section 7 – SHORT ESSAY STATEMENT

Explain in 300 words your reasons and expectations for joining this exchange programme and a brief

description of your future plan in research. Please use additional sheet(s) if necessary.

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Applicant Name:______________________________________________________

(Please print)

Applicant Signature:_________________________Date:______________________

Form for Indication of Priority Choice for

Charles K. Kao Research Exchange Scheme 2020

Referring to the list of potential hosts for the summer research exchange 2020, please pick 3 priority choices from the list of potential hosts for the Charles K. Kao Research Exchange Scheme 2020 by entering the code number and name(s) of supervisor(s) of the potential hosts in the table below.

Your name: _________________________________________

Your USID: _________________________________________

Your major: _________________________________________

|Priority Choice |Please enter the code no. and name(s) of supervisor(s) of potential hosts |

|Sample only |(8) Prof. Abraham Lee |

|Your 1st priority | |

|Your 2nd priority | |

|Your 3rd priority | |

Please return the application form by 20 November 2019 by email to Ms. Stella Ng (stellang@cuhk.edu.hk).

Notes:

- This is only an indication of preference choice and does not constitute a success of your application.

- The selection of candidates will be based on merits and this indication of preference does not affect your chance of success of application.

- The final acceptance of the students screened and selected by the Faculty in this selection exercise is still subject to the approval by the hosting institutions and the Professor Charles K. Kao Research Exchange Scholarship Committee of the University.

- The Faculty is not liable if any selected student fails to go for the exchange subsequently for whatever reasons (e.g. time delay in processing the student’s application by the hosting institutions, unsuccessful visa application, etc.) which are not controllable by the Faculty.

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SECTION 8 – DECLARATION

1. I declare that the information given in support of this application is accurate and complete. I understand that any misrepresentation will result in disqualification of my application for admission and subsequent participation in the exchange programme.

2. I authorize The Chinese University of Hong Kong (CUHK) to use my data to carry out checks on records of previous studies in CUHK and other institutions.

3. I authorize the Faculty of Engineering and Office of Admissions and Financial Aid to collect and verify my GPA with the Registration and Examinations Section and make use of my GPA for exchange programme's selection purpose.

4. I understand that the offer is contingent on my status as a full-time CUHK student in good standing at the time of participating in the exchange programme.

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