Inclusive Activity Fund Application

SEN Service, Wellness and Counselling Centre, office of Student Affairs

Applicants should submit the application at least two months prior to the activity.

For student groups, please provide the following particulars for the principal and vice coordinators of this application:
-Full Name
-Student ID No.
-Year of Study
-Affiliated College
-Contact No.
-Email Address

Last updated: July 2023

Applicant Category
1. Which of the following are you applying on behalf of? *

1. Which of the following are you applying on behalf of? CUHK College/Department/Unit Student Organization/Society/Interest Group Registered/Affiliated with OSA Informal Student Group
1b. Student Group Name *
Applicant Particulars
2. Name of Responsible Staff 2. Name of Responsible Staff * First Last
Also the contact person for this application
3. Post *
4. Affiliated College/ Department/ Unit *
5. CUHK Email Address *
6. CUHK Contact Number *
Applicant - Principal Coordinator & Contact Person Particulars

The below person will be the principal contact person for this application.
2. Name of Chief Coordinator 2. Name of Chief Coordinator * First Last
Also the contact person for this application
3. Student ID No. *
4. Year of Study *
4i. Year of Study (Other) *

UG/PG Year #
4ii. Affiliated College *
5. Contact No. *
6. Email Address *
Applicant - Vice Coordinator Particulars

The below person will be contacted only if the principal coordinator cannot be reached.
2a. Name of Vice Coordinator 2a. Name of Vice Coordinator * First Last
Also the contact person for this application
3a. Student ID No. *
4a. Year of Study *
4ai. Year of Study (Other) *

UG/PG Year #
4aii. Affiliated College *
5a. Contact No. *
6a. Email Address *
Proposed Activity Details
7. Activity Name
8. Date(s) & Time *
9. Activity Nature *

9. Activity Nature Talk/ Seminar Workshop Outing/ Visit Voluntary Service Promotional Campaign/Booth Exhibition Publication Other Other
10. Activity Objectives and Intended Outcomes (no more than 300 words)
Maximum of 300 words allowed. Currently Entered: 0 words.
Input can be in paragraph/ point forms.
11. Activity Content/ Highlight(s) *
Maximum of 1000 words allowed. Currently Entered: 0 words.
12. Expected Number of Beneficiaries *
13. Target Participants (e.g. UG/ PG students? staff? all CUHK/ designated College/ Faculty students? etc.) *
Implementation Plan
14. Names of Internal Units/ External Parties (if any; "N/A" if none) *
15. Implementation Timeline (promotion, recruitment, etc.) *
16. Expected Difficulties and Possible Solutions *
Budget
16. Total Estimated Cost of the Activity (HK$) *
17. Amount of Funding Requested from SENS (HK$) *

Funding amount is capped at $6,000 and is subject to the actual expense amount incurred.
18. Budget Breakdown *
19. Please list below any other funding source(s) and amount available for this activity, if any.
Others
20. Remarks (if any)

Please let us know if there are any other information you wish to provide.
21. Attachment for Additional Information (if any)

Attach Files
Disclaimer The personal data collected will be used by SEN Service (SENS) and authorised personnel for processing the captioned purposes in accordance with relevant provisions of the Personal Data (Privacy) Ordinance.

Inclusive Activity Fund Application

Applicant Category

Applicant Particulars

Applicant - Principal Coordinator & Contact Person Particulars

Applicant - Vice Coordinator Particulars

Proposed Activity Details

Implementation Plan

Budget

Others