Record Form for the 'Self and The Significant Others' Programme (Term 2, 2024–25)
To enhance students’ interactions with people from different social and cultural backgrounds, it was proposed by the Dean of Students (DoS) and approved by the Assembly of Fellows via Circular 005/2023 on 28 July 2023 that a new initiative, namely ‘Self and The Significant Others’, be introduced to students and as a signature programme from the academic year 2023–24 onwards.
Students are urged to invite one of their significant others, who may be anyone of the following, to join a cultural activity organized by
other CUHK units or external organizations
during Term 2.:
o Any CWC student from a different year;
o Any CWC student from a different major;
o Any CWC student who speaks a different native language;
o Any relative (e.g., cousin) or member in the student’s immediate family (e.g., grandparent); this person should not be a CWC student;
o Any CUHK student from a different college.
Students and their significant others are invited to join a
Activities arranged by the College Office, Residential Tutors (RTs), and student bodies are
NOT
considered for this programme, and attending these will count as one activity each only.
Students engaging in this programme and submitting the online form by the deadline (see below), will have their attendance records doubled (i.e., 1 activity = 2 attendance records) after review.
Each invitee cannot have previously participated as the invitee of the same student in any prior activities.
In addition, students joining the programme with genuine financial needs supported by proofs may apply for a one-off subsidy (HK$200 per CWC student per activity) from the College on reimbursement basis. The College will handle all subsidy applications in one go in April 2025.
Submission Deadline: 23 Apr 2025 (Wed, 5pm)
Part I) Personal Particulars
Name
Name
*
First
Last
Student ID
*
Year of Study
*
Email
*
Part II) Record of Activities Attended
Note that activities arranged by the College Office, Residential Tutors (RTs), and student bodies are NOT considered for this programme, and attending these will count as one activity each only.
Activity 1
Name of the Significant Other
*
Relationship with you (e.g. Family member/ College-mate/ CUHK student)
*
Activity Name
*
Organiser (Please state full name)
*
Date(s) of participation (e.g. 6 Jan, 4 Feb, 15 Mar 2025)
*
Event duration (in minutes)
*
Event source (e.g. webpage, link, YouTube, etc.)
*
Nature of activity (e.g. concert/ opera/ play/ drama/ exhibition/ talk show/ cultural tour/ art fair/ museum tour)
*
Short description and/or reflection (200 words,
either English or Chinese
) of the experience
*
Photo taken with the Significant Other during participation of this activity
*
Attach Files
Activity 2
Name of the Significant Other
Relationship with you (e.g. Family member/ College-mate/ CUHK student)
Activity Name
Organizer (Please state the full name)
Date(s) of participation (e.g. 6 Jan, 4 Feb, 15 Mar 2025)
Event duration (in minutes)
Event source (e.g. webpage, link, YouTube, etc.)
Nature of activity (e.g. concert/ opera/ play/ drama/ exhibition/ talk show/ cultural tour/ art fair/ museum tour)
Short description and/or reflection (200 words,
either English or Chinese
) of the experience
Photo taken with the Significant Other during participation of this activity
Attach Files
Activity 3
Name of the Significant Other
Relationship with you (e.g. Family member/ College-mate/ CUHK student)
Activity Name
Organizer (Please state the full name)
Date(s) of participation (e.g. 6 Jan, 4 Feb, 15 Mar 2025)
Event duration (in minutes)
Event source (e.g. webpage, link, YouTube, etc.)
Nature of activity (e.g. concert/ opera/ play/ drama/ exhibition/ talk show/ cultural tour/ art fair/ museum tour)
Short description and/or reflection (200 words,
either English or Chinese
) of the experience
Photo taken with the Significant Other during participation of this activity
Attach Files
Activity 4
Name of the Significant Other
Relationship with you (e.g. Family member/ College-mate/ CUHK student)
Activity Name
Organizer (Please state the full name)
Date(s) of participation (e.g. 6 Jan, 4 Feb, 15 Mar 2025)
Event duration (in minutes)
Event source (e.g. webpage, link, YouTube, etc.)
Nature of activity (e.g. concert/ opera/ play/ drama/ exhibition/ talk show/ cultural tour/ art fair/ museum tour)
Short description and/or reflection (200 words,
either English or Chinese
) of the experience
Photo taken with the Significant Other during participation of this activity
Attach Files
Part III) Application for One-off College Subsidy
1. Please inform the College on the type(s) of financial aid that you have applied for/ been granted for the academic year 2024–25 with the amount approved (if applicable)
Put N/A if not applicable
Tertiary Student Finance Scheme – Publicly-funded Programmes
Application status and amount granted (HK$):
*
Government Non-means-tested Loan Scheme
Application status and amount granted (HK$):
University Bursaries and Loans
Application status and amount granted (HK$):
College Bursaries
Application status and amount granted (HK$):
Others (please specify), with application status and amount granted (HK$):
I have not applied for any of the above financial aid for the following reason(s)
2. I would like to apply for one-off subsidy from the College
*
2. I would like to apply for one-off subsidy from the College
Yes
No
Reason(s) of applying for this one-off subsidy
Supporting proof, including the receipts of event(s) for reference
Attach Files
Declaration
I declare that all information provided above and in the supporting proof(s) attached are valid and complete to the best of my knowledge. I understand that I should take full responsibility if I knowingly supply false information to CW Chu College, and the College reserves the right to refer my case to the Dean of Students/ relevant Committee for investigation should this happen.
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.
Enquiries:
Ms Rosanna So, Executive Officer
Tel: 3943 1943
Email: rosannaso@cuhk.edu.hk
Disclaimer
The personal data collected will be used by CW Chu College (CWC) and authorised personnel for processing the captioned purposes in accordance with relevant provisions of the Personal Data (Privacy) Ordinance.