Short Courses in Public Health (2024-2025, Summer Term)

Title

Title Mr. Ms. Miss. Prof. Dr.
English Full Name (Same as HKID)
eg. Chan Tai Man
Chinese Name (Same as HKID)
Sex

Sex Male Female
HKID
Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Telephone Number
Email
Academic Qualifications (Please list in chronological order.)
Institution, Date of Attendance (From/ To), Major/Minor, Diploma/Degree
Professional Qualifications
(Award Body and Year Obtained)
Working Experience (Please list in chronological order.)
Institution, Position and Years in the Position
Certificate of academic/ professional qualifications
(e.g. diploma/ certificates or other qualifications)

Attach Files
Application for Course

Application for Course HSOC5103 Lecture series in Non-communicable Diseases as Public Health Concerns | $11,000 PBHT6802 Global and Regional Perspectives on Noncommunicable Diseases Prevention and Control | $5500 POPG5006 Disaster and Humanitarian Crisis | $11,000
Please select either one of the below,

Please select either one of the below, Certificate of Completion (Students are required to obtain a ‘satisfactory pass’ in the assessment for the specified module. ) Certificate of Attendance (Students who attended at least 60% of the lectures, seminars, tutorials, and practical sessions but did not take the assessment would be awarded a “Certificate of Attendance” instead.)
I will send the following to Room 202, 2/F, School of Public Health Building, Prince of Wales Hospital, Shatin, N.T. with subject: Short Course in Public Health

I will send the following to Room 202, 2/F, School of Public Health Building, Prince of Wales Hospital, Shatin, N.T. with subject: Short Course in Public Health an application fee of HK$100.00 (A crossed personal cheque or bankdraft, payable to The Chinese University of HK")
Rental of Guest Card

The main entrance of the JC School of Public Health and Primary Care building is locked after 6:00 pm. To allow short course students to access JCSPHPC building during non-office hours, the rental service of the access card is offered as follows:

Refundable deposit: HK$100
Loan period: From the date collected the card to the last class of the course

Important notes:
1. Deposit will be refunded to students upon return of the guest card on or before your last lecture. If you fail to return the guest card on time, the deposit will not be refunded.
2. The guest card should be returned to the programme administrator if you take leave for a term or longer.

Please indicate your choice below. The application form will be provided via email upon confirmation of the application by the programme administrator.
Would you like to rent the guest card?

Would you like to rent the guest card? Yes No
Signature

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.
Remark

1. I understand that the application fee, one paid, is not refundable.
2. Acceptance of application is subject to the course.

I declare that the information given in support of this application is accurate and complete, and understand that any misrepresentation will result in the disqualification of my application for admission.
Disclaimer The personal data collected will be used by JC School of Public Health and Primary Care - Master of Public Health Programme and authorised personnel for processing the captioned purposes in accordance with relevant provisions of the Personal Data (Privacy) Ordinance.

Short Courses in Public Health (2024-2025, Summer Term)

Rental of Guest Card

Remark