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
Exit qualification(s) that students will be obtained upon graduation (You may choose more than one)

Exit qualification(s) that students will be obtained upon graduation (You may choose more than one) IB Diploma GCE A-Level / International A-Level SAT / ACT & AP HKDSE Others, please specify Others, please specify
Type of Activity

Type of Activity Campus Visit (to CUHK) Admission Talk (at your school) Others (please specify proposed activity)
Student population (No. of local students)
Grade 9
Qualification(s) of Grade 9 students

Qualification(s) of Grade 9 students IB Diploma GCE A-Level / International A-Level SAT / ACT & AP HKDSE Others, please specify Others, please specify
Grade 10
Qualification(s) of Grade 10 students

Qualification(s) of Grade 10 students IB Diploma GCE A-Level / International A-Level SAT / ACT & AP HKDSE Others, please specify Others, please specify
Grade 11
Qualification(s) of Grade 11 students

Qualification(s) of Grade 11 students IB Diploma GCE A-Level / International A-Level SAT / ACT & AP HKDSE Others, please specify Others, please specify
Grade 12
Qualification(s) of Grade 12 students

Qualification(s) of Grade 12 students IB Diploma GCE A-Level / International A-Level SAT / ACT & AP HKDSE Others, please specify Others, please specify
Student population (No. of non-local students)
Grade 9
Qualification(s) of Grade 9 students

Qualification(s) of Grade 9 students IB Diploma GCE A-Level / International A-Level SAT / ACT & AP HKDSE Others, please specify Others, please specify
Grade 10
Qualification(s) of Grade 10 students

Qualification(s) of Grade 10 students IB Diploma GCE A-Level / International A-Level SAT / ACT & AP HKDSE Others, please specify Others, please specify
Grade 11
Qualification(s) of Grade 11 students

Qualification(s) of Grade 11 students IB Diploma GCE A-Level / International A-Level SAT / ACT & AP HKDSE Others, please specify Others, please specify
Grade 12
Qualification(s) of Grade 12 students

Qualification(s) of Grade 12 students IB Diploma GCE A-Level / International A-Level SAT / ACT & AP HKDSE Others, please specify Others, please specify
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
Number of Students
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
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.

CUHK - Online Request Form for Campus / School Visit

Student population (No. of local students)

Student population (No. of non-local students)