Enrolment Form: The ICA Scheme - Qipao Experience in Old Hong Kong

Enrolment Form: The ICA Scheme - Qipao Experience in Old Hong Kong

Date: 27 November 2024 (Wednesday)
Time: 8:45am-5:00pm
Venue: Outside campus

Free of charge. ($100 refundable deposit)
Quota: 20 (If the number of registrants exits the quota, successful applicants will be determined by drawing lots.)

SID
Name Name First Last
Contact no.
Email address
Team name
I am a/an

I am a/an Local student Mainland student International student Exchange student
I'm a

I'm a Undergraduate student Postgraduate student
Year of Study

Year of Study Year 1 Year 2 Year 3 Year 4
Place of Origin
Are you residents of I-House?

Are you residents of I-House? Yes No
Please read and confirm the Undertakings (Please tick to indicate your consent)

Please read and confirm the Undertakings (Please tick to indicate your consent)
OSA and/or the co-organising organisation(s) may use and retain any photographs or videotapes (collectively, "Materials") of the Participants which may be taken during the programme, for any purpose and in all forms without incurring any liability to the Participants or any person (including the requirement to pay any compensation in respect of such use of the Materials). I understand that my contact information may be shared with other International Cultural Ambassadors or University units for the purpose of the International Cultural Ambassador Scheme and other University activities
Disclaimer The personal data collected will be used by Office of Student Affairs (OSA) and authorised personnel for processing the captioned purposes in accordance with relevant provisions of the Personal Data (Privacy) Ordinance.