Notification for Leave of Absence

Surname (BLOCK letters in English) *
Given Names (BLOCK letters in English) *
Full name (in Chinese) *
Year of Admission *
Must be a number less than or equal to 4.
Programme Enrolled *
Leave period (from) * / DD / MM YYYY
Leave period (to) * / DD / MM YYYY
Reason:
*
Upload Supporting document (eg medical certification) *

Attach Files Attach Files
Frequently Checked Email Address *
Draw your signature into the box below. *

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Notes to the applicants
1. The personal data provided on this form will be used by the Continuing Professional Education, Department of Social Work Hong Kong for the purpose of processing this application.
All information provided, when no longer required, will be destroyed.
2. For correction of or access to the personal data after submission of this form, please contact the Continuing Professional Education, Department of Social Work.
3. Information provided on this form may be transferred to other departments/administrative units within CUHK for consideration and granting approval, where applicable.
Disclaimer

The personal data collected will be used by Continuing Professional Education, Department of Social Work 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.
Type the letters you see in the image below.