Ref. No. Course Issues Application Form (for Full-time and ...

1 Ref. No. _____. Course Issues Application form (for Full-time and Part-time programmes, except DYJ and Overseas Degree programmes). Please return this form with the supporting documents (if any) to our Admission Counter at Kwai Hing or OUHK-CITA Campus. Payment could be made by EPS/Credit Card/crossed cheque payable to "The Open University of Hong Kong". 1. Personal Particulars Name: Mr. / Ms. _____ (English) _____ (Chinese). HKID / Passport No.: _____ Student No.: _____ Teaching Venue: _____. If you would like to change your personal contact information in our student record, please tick as appropriate and complete the relevant information. Contact Phone No.: _____ (Home / Office) _____ (Mobile). Fax: _____ Email: _____.

2 Correspondence Address: _____. 2. Item(s) of Application (Please tick as appropriate). Your Application will only be processed after the administrative fee is settled (which is non-refundable unless other specified, regardless of whether your Application is approved or not). Non-refundable*. Item Remarks Administrative Fee a) Exemption: Please list and provide the copies of relevant documents in support of your Individual courses in Application . Certificate /Diploma / Higher $450 per Course Application must be made within 2 weeks after the commencement of a semester. Diploma Exemption for courses under $300 per Course Exemptions are only granted up to a maximum of 2 courses. DB003 Professional Diploma in Applicable to students from other CFPcm accredited education providers (Please refer Personal Financial Planning.

3 N/A to Website: ). Exemptions are only granted up to a maximum of 2. courses. Exemption for the Course Applicants are required to have at least 3 years of relevant working experience and to VET3003CP Practicum for Pet undertake a challenging examination set by LiPACE. Dog Grooming under DH020. $2,500 per Course Diploma in Professional Grooming and Care for Pet Dogs . b) Withdrawal N/A Except for unsuccessful applications and Course cancellation, tuition fees paid are not c) Programme/ Course Fee Refund: refundable. The Director of the Institute reserves the right to waive this condition and consider partial refund under extreme circumstances for legitimate applications which $250 are provided with supporting documents and received within 14 days after Course For Full-time and its part-time programmes commencement.

4 For professional programmes and certificate courses If the applied programme / Course is already over-subscribed or cancelled, either a $250 per Course refund, transfer to another programme/ Course , or deferment to next intake is permitted without charge. d) Class Transfer N/A Application must be made within 14 calendar days after Course commencement. e) Programme/ Course Transfer: Please provide supporting documents for justification. $300. For Full-time and its part-time programmes For professional programmes $300 per Course and certificate courses f) Teaching Venue Transfer N/A. g) Deferment of Study $300 per Course h) Deferment of Examination: Application must be made within 7 calendar days after examination.

5 Please provide supporting documents for justification. N/A. For Full-time and its part-time programmes For professional programmes $250 per Course and certificate courses i) Resit Examination / Re-assessment Application must be made within 7 calendar days (for FTD/PTD)/ 14 calendar days (for Part-time Certificate / Professional Programme) of results announcement. $220 per Course The highest Overall Grade obtainable in re-assessment will be capped at C for Professional & Full-time Programmes and D for Diploma Yi Jin Programme. j) Appeal against Results Application must be made within 7 calendar days (for FTD/PTD)/ 14 calendar days (for Part-time Certificate / Professional Programme) of results announcement. $650 per Course *Remarks: The fee is refundable for successful cases of appeal in the circumstances that a more favorable Course result is awarded.

6 1 FFT008E-J20180605. Non-refundable Item Remarks Administrative Fee k) Student Card Issuance / Please attach a recent photo (3cm x ) with your name, student number and $100. Replacement programme code written on the back (only applicable to current students). l) Certificate of Attendance Please make sure that you have met the attendance requirement of the Course $300 concerned. Letter/Certificate of Completion m) Re- issue of Certificate/Diploma $300 per Course Award n) Additional Official Transcript (per $100. copy for professional programmes). o) Overdue payment charge For those deferred payment applicants who have failed to settle the tuition fee $500. balance before the approved deadline. p) Re-registration charge For those students who are de-registered but would like to reinstate their study in the $500.

7 Same programme. q) Visa fee (for non-local student) $500 Only applicable to Full-time programmes r) Certificate of Payment N/A. For Full-time and its part-time programmes For professional programmes $100. and certificate courses 3. Relevant Programme / Course Information (for all items). Programme/ Course code and title: _____. Original Programme/ Course For Office Use Only Prog/. Course Programme/ Course Intake No. of Class Course Exam/End code title Class (YYYY/ MM) enrolment size start date date Course status+. No. of Class Course Exam/End Transferred/ deferred/ changed venue to * : . enrolment size start date date Course status+. Provided by _____ Date: _____. * Please ensure that there will be no time clash between the chosen courses with your other enrolled courses.

8 + Course status (confirmed, pending or cancelled). 4. Bank Account Information for Refund (for item c only). Please refund the deposit/ programme fee/ Course fee to the following bank account (if my Application is approved): Account Name _____. Account Number _____. Bank _____. ~ If the applicant is not the holder of the bank account, please provide an authorization letter. 5. Reason(s) for Application _____. _____. Supporting Document(s) Attached Medical Certificate Company Letter Certificates Others (Please specify) _____. I hereby pay the non-refundable administrative fee for my Application by an enclosed cheque of HK$_____ (Cheque No. _____ Bank: _____) . Signature: _____ Date: _____. 51 53 LiPACE Office & Kwai Hing Campus: 8/F 11/F, Tower 2, Kowloon Commerce Centre, 51 53 2 8 11 Kwai Cheong Road, Kwai Chung, (852) 3120 9988 Tel: (852) 3120 9988 (852) 2381 8456 Fax: (852) 2381 8456 201 203 OUHK CITA Campus: 201 203 Lai King Hill Road, Kwai Chung, (852) 3568 0494 Fax: (852) 3568 0494 Email: Website: 2 FFT008E-J20180605.

9 For Office Use Only Appeal against Results (for item j only). To be completed by PL. Original Course Result Information Verified Course Result after Appeal Attendance (%) _____ Required minimum attendance _____%. Verified Result Weighting Overall Pass CA Marks _____ _____ CA_____ % Yes Exam Marks _____ _____ Exam_____ % No Overall Marks _____ _____ 100%. Final Grade _____ _____. by_____ Date: _____. Comments and Recommendation^: Class transfer within same Course Course transfer within same programme Course transfer of different programme Different teaching venue transfer Recommended* Not Recommended by PL and TL [for items (a) and (j)]. AM (ST-PA) [for items (d) to (f)]. AM(ASO) [for items (b), (o), (p) to (r)].

10 AM (ASO) and UIC(RU) [for item (c) only] . AM(EGO) [for items (h), (i), (l) to (n)]. AM(TTO) [for item (k) only]. UIC(RU) for Subject Team [for item (g) only]. Signature:_____ Date: _____. _____. Approval^: Administrative fee waived / refunded Approved Not Approved by TL [for items (d) to (f)]#. UIC(RU) [for items (b), (k) to (p) & (r)]. PMC Chair [for items (a), (g) to (j), (q)]. D/DD [for item (c) and cases with financial implications]. Signature:_____ Date: _____. ^ Please provide clear and specific information (such as programme / Course code and title, exact amount) to facilitate communication, implementation and recording. applications for refund cases need to follow the Institute's refund policy and be approved by D/DD.