Leadership Qualities Centre, Office of Student Affairs
Online Application Form
Summer Service Trip Series 2018-2019

For more information about the captioned programme:
Community Outreach Programme @ East Java, Indonesia 印尼社區建設服務學習計劃 (COP):
Date: 18 July - 8 August 2019 (24 days)
https://sa.hkbu.edu.hk/lqc/sl/service-learning/indonesia-east-java-community-outreach-programme

Kenya House Building Service Tour 2019 肯亞建屋服務之旅 2019 (Kenya):
Date: 17-28 May 2019 (12 days)
https://sa.hkbu.edu.hk/lqc/sl/service-learning/kenya-house-building-service-tour

Tsing Hua Summer Service and Learning Program中外師生暑期社會實踐 (Tsing Hua):
Date:
A) 3-20 July 2019 (18 days)
B) 6-23 July 2019 (18 days)
https://sa.hkbu.edu.hk/lqc/sl/service-learning/vtp

PART 1 - WHICH PROGRAMME DO YOU WANT TO APPLY FOR? PLEASE INDICATE YOUR PREFERENCE.

Community Outreach Programme (COP)
Kenya House Building Service Tour (Kenya)
Tsing Hua Summer Service and Learning Program
[3-20 Jul 2019] (Tsing Hua A)
Tsing Hua Summer Service and Learning Program
[6-23 Jul 2019] (Tsing Hua B)

PART 2 - PERSONAL PARTICULARS

Full name in English *
(e.g CHAN Tai Man)
Full name in Chinese *
Student ID *
Study Year *
Date of Birth (DD-MM-YYYY) *
Faculty/School *
Major *
Mobile no. *
BU email *
(e.g. 16000000@life.hkbu.edu.hk)
Personal Email *
cGPA
(For the applicant of COP & Kenya)
Had you received Reaching Out Award (ROA) before?
[if yes, please specify the year of award.]
(For the applicant of COP & Kenya)

PART 3 - AVAILABILITY FOR INTERVIEW (PLEASE SELECT AT LEAST THREE SESSIONS.)

27 Feb (Wed) 10:35-11:25 *
27 Feb (Wed) 11:35-12:25 *
27 Feb (Wed) 14:35-15:25 *
27 Feb (Wed) 15:35-16:25 *

28 Feb (Thu) 10:35-11:25 *
28 Feb (Thu) 11:35-12:25 *
28 Feb (Thu)14:35-15:25 *
28 Feb (Thu) 15:35-16:25 *

PART 4 - AWARDS/ACHIEVEMENTS/EXTRA-CURRICULAR INVOLVEMENT

1. Year/Duration (From mm/yyyy to mm/yyyy)
(e.g. 07/2010 to 08/2010)
Event/Activity
Position/Achievement

2. Year/Duration (From mm/yyyy to mm/yyyy)
(e.g. 07/2010 to 08/2010)
Event/Activity
Position/Achievement

3. Year/Duration (From mm/yyyy to mm/yyyy)
(e.g. 07/2010 to 08/2010)
Event/Activity
Position/Achievement

4. Year/Duration (From mm/yyyy to mm/yyyy)
(e.g. 07/2010 to 08/2010)
Event/Activity
Position/Achievement

5. Year/Duration (From mm/yyyy to mm/yyyy)
(e.g. 07/2010 to 08/2010)
Event/Activity
Position/Achievement

PART 5 - ADDITIONAL INFORMATION

Please briefly introduce yourself. *
Please briefly explain why do you want to join this programme and your expectation. *