CUAAA Award

THE CHINESE UNIVERSITY OF HONG KONG

School of Architecture

CUAAA Award 2016

APPLICATION FORM

The information provided will be used for Scholarships/Awards-related purposes in the University. It may be

accessible to offices, committees or persons who will process Scholarships/Awards matters. Information on

unsuccessful candidates will be destroyed when no longer required.

1.Personal Particulars / RECENT
PHOTO
Name (English) / (Chinese)
Gender / Date of Birth / Place of Birth
Nationality / HKID No. / Student ID
College / Major / Minor
Current Year of Study / Length of Study / / / Expected Graduation Year / / / (MM/YY)
Email / Mobile
Home Address
Emergency Contact
Name / Name
Relationship / Relationship
Contact Number / Contact Number
2.Academic Results
Year GPA
Year 1 / Year 2 / Year 3 / Year 4 / MArch 1
Studio Grades
U1 / U2 / U3 / U4 / U5 / U6
Studio I / Studio II
3.Language Abilities (other than Chinese and English)
4.Details of Awards Received at CUHK (Please list in chronological order)
Year / Name of Award / Amount
=
5.Extra-Curricular Activities/Community Service (Please list in chronological order)
Year / Student Society / Community Activities / Post / Contribution
6.Working Experience (Please list in chronological order)
From / To / Name of Company/Employer / Position / Full-time / Part-time
7.Travel Experience(Please list in chronological order)
From / To / Country/ Region(s)/ Cities / Travel Details*
*Please specify the travel aims, organization name that organized the travel, subsidies received, if any, etc.
8.Detailed Programme Plan
Proposed Programme: Study/Apprenticeship/Travel* (*Please delete whichever is inappropriate)
Location of the proposed programme:
Name of your supervisor for your proposed programme:
Specify yourprogrammeplan with dates, if possible, and also the places that you propose to visit
From / To / Place to visit (e.g., building/museum/landmark, etc.) / Remarks (if any)
9.Study Focus of your Programmebased on your research conducted before the trip
(Please detail the study focus of your proposed programme based on your research. You may attach a separate sheet if necessary.)
10.Statement of how the CUAAA Award will benefit your further education and career.
11.Family and Financial Status
Total Number of Household Members (including applicant):
Table 1 –Income of Household Members
Name / Gender/Age / Relationship / Occupation / Monthly Income (HK$)
/ / Applicant
/
/
/
/
/
Total :
Table 2 –Other Income(e.g. pension, public assistance, compensation, rents, interest from fixed deposits, dividends, etc.)
Description / Monthly Income (HK$)
Total:
Table 3 –Housing(* Please delete whichever is inappropriate.)
Housing : / Rented/Purchased * / Monthly Rent or / HK$
Purchase Installment Paid :
Table 4 –Government Grant and Loan(* Please delete whichever is inappropriate.)
Did you apply for the Government Grant and Loan for the current academic year?Yes/No *
If yes, Government Grant : / HK$ / Loan : / HK$
If no, please explain reason(s) for not applying :
12.Details of other Awards for Study/Apprenticeship/Travel applied for the current academic year or awarded: (Please list in chronologicalorder)
Name of Award / Amount(HK$) / Academic Year
Applied for/Awarded * in / /
Applied for/Awarded * in / /
Applied for/Awarded * in / /

(*Please delete whichever is inappropriate)

13.Authorization and Undertaking
I hereby authorize the School of Architecture of The Chinese University of Hong Kong to obtain any information from other units of the University which the School deems necessary and relevant to the administration and assessment of my application for the CUAAA Award 2016.
I also undertake to inform the School of Architecture as soon as practicable of any Awards/Scholarships/ Prizes conferred to me for Overseas Study/Apprenticeship/Travel for the year 2016after submission of this application.
Signature of Applicant : / Date :
Notes: / Students should submit the following documents in personduring office hours toMs Isabel Wong of the General Office, AIT Building, CUHK, on or before 9 May 2016 (Monday). Shortlisted applicants will be invited to attend a selection interview to be held in May 2016.
a) / Completed application form.
b) / Copy of academic transcript(s), including results of the first term of AY 2015/16.

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