Notification for Leave of Absence
Notification for Leave of Absence
Surname (in English)
*
Given Names (in English)
*
Full name (in Chinese)
*
Year of Admission
*
Must be a number between
4
and
4
Programme Enrolled
*
Leave period (from)
Leave period (from)
*
/
MM
/
DD
YYYY
Leave period (to)
Leave period (to)
*
/
MM
/
DD
YYYY
Reason
*
Upload Supporting document (eg medical certification)
Attach Files
Frequently Checked Email Address
*
Draw your signature into the box below.
Draw
or
Type
I understand this is a legal representation of my signature.
Clear
Full Name
I understand this is a legal representation of my signature.
Notes to the applicants
1. The personal data provided on this form will be used by the Continuing Professional Education, Department of Social Work Hong Kong for the purpose of processing this application.
All information provided, when no longer required, will be destroyed.
2. For correction of or access to the personal data after submission of this form, please contact the Continuing Professional Education, Department of Social Work.
3. Information provided on this form may be transferred to other departments/administrative units within CUHK for consideration and granting approval, where applicable.
Disclaimer
The personal data collected will be used by Continuing Professional Education, Department of Social Work and the authorised personnel for processing captioned purposes only. All personal data you provided will not be disclosed to any third parties unless with your prior consent.