Short Courses in Occupational and Environmental Medicine | Health Practice | Hygiene 2021-2022 Intake Application Form (SC_11/2020)

Applications will be processed only upon receipt of the completed application form, copies of supporting documents and application fee, which are submitted at least 3 weeks before the course commencement.

1Personal Information > 2Academic Qualifications > 3Professional Qualifications > 4Working Experience > 5Course Application > 6Supporting Documents > 7Submission > 8Review Your Entry
Title *

Title Prof. Dr. Mr. Ms.
Sex *

Sex M F
Name (In English) Name (In English) * First Last
(e.g. First Name: Tai Man; Last Name: CHAN)
Name (In Chinese)

(e.g. 陳大文)
Date of Birth Date of Birth * / DD / MM YYYY
HKID Card No. *

(e.g. A1234567)
Address *
Tel
Mobile *
Fax
Email *
Disclaimer The personal data collected will be used by Division of Occupational & Environmental Health, JC School of Public Health and Primary Care and the authorised personnel for processing captioned purposes only. All personal data you provided will not be disclosed to any third parties unless with your prior consent.