Application for Leading Change and Growth

Application for Leading Change and Growth

Program Dates: 25 October 2019
Time: 9:30am - 5:00pm
Venue: Executive Education Suite, 1/F, Cheng Yu Tung Building, The Chinese University of Hong Kong, Shatin, Hong Kong

You will receive notification from APIB once your application together with payment is received. APIB reserves the final right to decide the appropriate mix of participants to ensure the program quality.

Important Notes
1. APIB of CUHK Business School reserves the right to make any amendments to the program without prior notice.
2. For cancellation received in writing at least 4 weeks prior to the program commencement date, a refund of 50% of the program fee is
available.
3. All information collected will be kept confidential, and treated strictly in accordance with the University’s Policy on protection of personal
data. Personal data will be used for the purpose of program development, market research and direct mailing only.

Participant Information

Title

Participant Information Title Dr. Mr. Mrs. Miss Ms.
Full name Full name First Last
Contact Phone Number
Email
CUHK Alumni?

CUHK Alumni? Yes No
If yes, please specify the program and graduation year
Highest Academic Degree Obtained:
Company & Department / Unit:
Job title
Managerial Experience: (No of Years)
Area, scope and level of job responsibility:
Corporate Applicant Information (for corporate applicant only)

To enjoy corporate rate, please provide corporate information
Company / Organization:
Industry / Nature of Business:
Contact person information

Title

Contact person information Title Dr. Mr. Mrs. Miss Ms.
Full name Full name First Last
Job title
Department / Unit:
Contact Phone Number
Email
Correspondence Address:
Payment method
Make a cheque payable to "The Chinese University of Hong Kong" and mail to:
The Asia-Pacific Institute of Business (APIB)
The Chinese University of Hong Kong
Rm 846, 8/F, Cheng Yu Tung Building
No 12 Chak Cheung Street, Shatin, Hong Kong

Or

By credit card

Make a cheque payable to "The Chinese University of Hong Kong" and mail to: The Asia-Pacific Institute of Business (APIB) The Chinese University of Hong Kong Rm 846, 8/F, Cheng Yu Tung Building No 12 Chak Cheung Street, Shatin, Hong Kong Or By credit card I hereby authorize The Chinese University of Hong Kong (CUHK) to debit from my credit card account with the following details for the payment of program fee
Credit card type

Credit card type Visa Master
Total Amount to be debited (in Hong Kong Dollar)
Credit Card No.
Name Printed on Credit Card
Expiry Date (MM / YY)
Issuing bank
Disclaimer The personal data collected will be used by The Asia-Pacific Institute of Business (API) and authorised personnel for processing the captioned purposes in accordance with relevant provisions of the Personal Data (Privacy) Ordinance.