延迟缴交学费申请表 - OUHK.PDF

Application No. 申請編號: _______ Application for Deferred Payment of Tuition Fee 延遲繳交學費申請表 (for Full-Time Part-Time Programmes 全日制及兼讀制課程) Important Notes to Applicant Unless you or your family has genuine financial needs, such as under assistance of Comprehensive Social Security Assistance (CSSA) (supporting document is required), you are required to pay a deposit of HK$5,000 (Diploma∆, Higher diploma and Overseas Degree Programmes) while applying for defer payment of tuition fee. 除非你或你的家庭有特殊經濟需要，例如屬綜援受助家庭(需提交有關證明) ，否則於遞交表格時須繳交按金，金額為 HK$5,000 (文憑 ∆ 、高級文憑及海外學士學位課程) 。 ∆except Diploma Yi Jin 毅進文憑除外 Student Information 學生資料 Student Name 學生姓名 ：___________________________________(English 英文) (Chinese 中文) HKID No. 身份證號碼： ______________________ Student No. 學生編號： _______________________ Daytime Contact No. 日間聯絡電話：__________________ Study Mode 修讀模式：FT 全日制 / PT 兼讀制* Programme Type 課程類別* ：DYJ 毅進 / Diploma 文憑 / Higher Diploma 高級文憑 / Overseas Degree 海外學位課程* Programme Code Title 課程編號及名稱：_______________________________________________________ Intake of Study 入學年份：______________________ Class 班別：_________________________________ Tuition Fee 學費 HK$__________________ Year 學年 _______________Semester 學期* Autumn/Spring * Delete as appropriate請刪去不適用者 I write to apply for deferment / further deferment* of tuition fee payment for the following reason: 本人現申請延遲/再度延遲* 繳交學費，原因如下： □ I am applying for the FASP/NLSPS/ENLS* from the Student Financial Office (SFO) on _________________ (DD/MM/YYYY). 本人於_____________(DD/MM/YYYY) 向學生資助處申請專上學生資助計劃/免入息審查貸款計劃