Charged Wi-Fi Guest Accounts Application Form
For Student Organizations
Applicant must be the chairperson of the Student Organizations
Policies and Guidelines
- Student organizations can apply for charged Wi-Fi guest accounts for their event/conference/activity participants.
- Each account is charged at HK$10/day. Multiple-login is strictly prohibited.
- The Chairperson of the Student Organization will be notified with the application result through e-mail in THREE working days.
- The appointed Coordinator shall be responsible for management of the computing resources granted to the student organization, and should work closely with ITSC on implementing relevant policies.
- Reference: Wi-Fi Service for Official Guests and Event/Conference/Activity participants:
Personal Data Collection
- The personal data provided on this form will be used by
- ITSC to verify your identity in the University to confirm your eligibility for the computing resources and services being provided by ITSC
- ITSC to contact you
- The provision of personal data on this form is voluntary. If you do not provide sufficient information, however, we may not be able to process your application.
- Personal data held by us relating to you will be kept confidential and will not be used for other purposes apart from the above.
- You have the right to check whether ITSC holds personal data on you. You can submit your request through Service Desk at in writing to “User Support Division, Information Technology Services Centre”.
- Details on the use of personal data by ITSC can be found at
Form Submission
- To expedite the process of your application, the information/documents must be supplied/produced/completed.
- You can scan and e-mail the form to
- The Chairperson will receivea reply through emailor phone in THREE working days.
- For any enquiries, please write to ITSC Service Desk at
Part I – To be completed by the Student Organization
Section A: General Information of the Student Organization
Student Organization AccountComputing ID
Student Organization Name
(in English)
Student Organization Name
(in Chinese, if applicable)
Contact E-mail Address / Contact Phone No.
Section B: Information of the Chairperson
Student ID No. / Name in Chinese(if applicable)
Contact E-mail Address / Contact Phone No.
Name in English
Session for Current Cabinet / Commence on
(dd/mm/yyyy) / End on
(dd/mm/yyyy)
Section C: Information of the Coordinator(if any, see Rules to Note Point #4 for details.)
(To be the primary contact on Wi-Fi Guest account matter)
Student ID No. / Name in Chinese(if applicable)
Contact E-mail Address / Contact Phone No.
Name in English
Section D: Charged Wi-Fi Guest Accounts Required
(Each account will be charged for HK$10 per day to use the Wi-Fi Service during event/conference/activity.)
Name of Event/Conference/ActivityDate of Event/Conference/Activity
(dd/mm/yy – dd/mm/yy)
Wi-Fi Service Access Period
(dd/mm/yy – dd/mm/yy) / Unit(s) of Day-pass Required (No. of days for Wi-Fi Access)
No. of Accounts Required
(one account per guest)
Charged amount for Wi-Fi Guest Accounts / () account(s) needed x () day-pass(es)x HK$10
Enclosed cheque amount: (HK$)
Section E: Cheque Payment Information
(Your application will not be processed by ITSC until we received your cheque payment. Please make a crossed cheque payable to “The Chinese University of Hong Kong”)
Enclosed Cheque No.Enclosed Cheque Amount / HK$
Bank Name
Bank A/C Holder Name
Bank A/C No.
Section F: Justification
Please provide the justification for using the Wi-Fi guest account(s) selected in Section D. Otherwise, your application may not be consideredand the form will be returned to you. Please use a separate sheet if necessary.
Section G: Authorization Statement
If the Chairperson needs to authorize another Committee member to submit and collect documents relating to this application, put a in below box, fill in the information and provide a photocopy of CU Link card of the authorized member.
[ ] / I hereby authorize / / / (Name / SID) on my behalf to submit and collectdocumentsrelating to this application.
Section H: Signature
Chairperson
Signature with Organization Stamp( )
Name in Print / Date
Part II – To be endorsed by the affiliated College Office or Office of Student Affairs
Staff / Computing ID No. / Title / Prof / Dr / Mr / Mrs / Ms / Name in Chinese(if applicable)
Name in English
Position
Contact E-mail
Address / Contact Phone No.
Department
Session for Current Student Organization Cabinet / Commence on
(dd/mm/yyyy) / End on
(dd/mm/yyyy)
I warrant that all the information given in Section A and Section Bof this application form is correct.
Endorsed by
Signature with Department Stamp( )
Name in Print / Date
Part III - Office Use Only
Received by / DateAuthorized by / Date
Processed by / Date
Remarks
Form guest_society.doc (Page1 of 4) 1/2018