CUHK - Online Request Form for Campus / School Visit

(for schools offering non-HKDSE curricula, such as IB, GCE A-Levels, SAT/ACT/AP, Canadian qualifications)

Dear Careers / Guidance Counselors,

You are most welcome to complete the form below if you / your students would like to
- visit our campus
- have our staff / teachers deliver an admission talk in your school.

Name of School *
Name of Contact Person *
Title *

Title Mr Mrs Ms Dr Other Other
Capacity *
Others (Please specify) *
Contact Telephone No. (Office) *
Contact Telephone No. (Mobile)
Email Address *
School Address *
Type of Activity *

Type of Activity Campus Visit (to CUHK) Admission Talk (at your school) Others (please specify proposed activity)
Type of Students *

Type of Students Grade 10 Grade 11 Grade 12

(You can select more than one item)
Number of Students *
Preferred Date:
Option 1 Preferred Date:
Option 1 * / DD / MM YYYY
Start Time Start Time * : HH MM AM/PM
End Time End Time * : HH MM AM/PM
Option 2 Option 2 / DD / MM YYYY
Start Time Start Time : HH MM AM/PM
End Time End Time : HH MM AM/PM
Preferred Faculties to be invited for the Activity (if applicable)

Preference 1 *
Preference 2 (Optional)
Preference 3 (Optional)
Preferred Topics of Presentation

Preference 1 *
Preference 2 (Presentation on a specific topic; please specify) (optional; subject to availability)
Preferred Language *

Preferred Language English Cantonese
Email
Email
Email
Email
Disclaimer The personal data collected will be used by Office of Admissions and Financial Aid (OAFA) and authorised personnel for processing the captioned purposes in accordance with relevant provisions of the Personal Data (Privacy) Ordinance.