InnoTech Scholarship 2020 Application Form

Innovation and Technology Scholarship 2020 Application Form (The University of Hong Kong)
Application Deadline - xx Dec, 2019

Read and follow the Application procedure and Eligibility & Criteria carefully prior to submitting your application. (details)
All candidates will be notified on or before xx of Feb 2020 for a Selection Interview in Match (TBC).
Read and Understand the instructions.*
Yes, I have
I. Personal Data:
Name in English:*
PrefixSurnameGiven Name
Name in Chinese:
姓名
E-mail Address (permanent) :*
Where the confirmation will be send to
Phone Number:*
Mobile No.
1
Home Tel No.
Mailing Address :*
Street Address
Street Address Line 2
LocationState / Province
Postal / Zip Code
Please upload a recent photo:*
Browse Files
.jpeg / .gif / .pngCancelof
II. Programme Information:
Faculty / Department:*
Programme of Study:*
Student Number:*
Year of Study:*
current yeartotal years of study
III. Academic Record:
Transcript
Cumulative GPA / CGA or class rankingMax point / class size
English Test Undertaken:*
HKDSE English LanguageTOEFLIELTS
English Test Score:*
(Overall)
*
(Listening and Integrated Skills)
*
(Reading)
*
(Writing)
*
(Speaking)
(Transcripts for both GPA/CGA and English test must be submitted together as supporting documents)*
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Qualifications and Open Examinations Result
Qualifications / Open Examinations (1):*
Secondary School / Institution (1)*
Results*
Subject Grade / Score
2
3
4
5
6
7
8
9
Qualifications / Open Examinations (2):
Secondary School / Institution (2)
Results
Subject Grade / Score
10
11
12
13
14
15
16
17
Qualifications / Open Examinations (3):
Secondary School / Institution (3)
Results
Subject Grade / Score
18
19
20
21
22
23
24
25
Academic Awards or Scholarships Received (secondary school, college and university)–
Date of Award Name of Award/Scholarship Awarding Institution
26
27
28
29
IV. Extra-Curricular Activities and Community Services (secondary school, college and university)
Provide maximum 6 Extra-Curricular Activities and Community Services for reference:*
Period
(dd/mm/yy-dd/mm/yy)
Name of Organisation Position Description of Duties
1.
2.
3.
4.
5.
6.
V. Preliminary Indication of University/Institution for Attachment Programme :
Number of Attachment Programme to be proposed:*
Total estimated cost:*
Attachment Programme 1
Host University/ Institution:*
Country:*
Course / Programme:*
Duration:*
weeks
Period:*
(DD/MM/YYYY - DD/MM/YYYY)
Host University/ Institution
Country Course / Programme Period
(DD/MM/YYYY - DD/MM/YYYY)
Estimated cost
Attachment programme 1
Trip 2
Trip 3
Trip 4
5.
6.
Brief description of the plan (not more than 200 words):*
0/200
Estimated cost of the trip:*
Cost (HK$) Remarks
Tuition and application fee
Accommodation and board
Books and other supplies
Airfare and visa application
Other mandatory cost
TOTAL
VI. Local Internship Programme (Optional):
Do you wish to join the optional internship programme if you are successfully awarded with the Scholarship? (please jump to section VII if your answer is No)*
YesNo
Preference of nature / field of the internship:
Preferred duration for internship:
weeks (maximum 12)
Preferred period for internship:
(DD/MM/YYYY - DD/MM/YYYY)
VII. Mentorship Programme:
Do you have preference for your mentor if you are successfully awarded with the Scholarship? (please jump to section VIII if your answer is No)*
YesNo
Preference of the academic field of your mentor:
Preference of learning aspects from the mentor:
(e.g. entrepreneurships, research, leadership skills)
(e.g. entrepreneurships, research, leadership skills)
VIII. Statement of Interest
Please write a statement of 300 to 500 words for the following question:

* How would your passion in Innovation and Technology benefit to the development of the society?
Statement:
0/500
IX. Declaration
1. I certify that all the information provided in this application is true and accurate to the best of my knowledge. In the event that any information is found untrue or inaccurate in future, the Scholarship Secretariat reserves the right to invalidate any application, withdraw the scholarship approved and require any payment made to be refunded.
2. I agree that information provided in this application will be used and/or disclosed by the Scholarship Secretariat to relevant parties to process the application as well as for related purposes, such as conducting selection interviews, monitoring of progress, etc.

By signing (typing your full name) in the space below, you agree with the above declaration. Please print for your records and retain as verification of your application.
E-Signature:*
Should be Empty:

	Cost (HK$)	Remarks
Tuition and application fee
Accommodation and board
Books and other supplies
Airfare and visa application
Other mandatory cost
TOTAL

	Subject	Grade / Score
2
3
4
5
6
7
8
9

	Subject	Grade / Score
10
11
12
13
14
15
16
17

	Subject	Grade / Score
18
19
20
21
22
23
24
25

	Date of Award	Name of Award/Scholarship	Awarding Institution
26
27
28
29

Innovation and Technology Scholarship 2020 Application Form (The University of Hong Kong)

I. Personal Data:

II. Programme Information:

III. Academic Record:

IV. Extra-Curricular Activities and Community Services (secondary school, college and university)

V. Preliminary Indication of University/Institution for Attachment Programme :

VI. Local Internship Programme (Optional):

VII. Mentorship Programme:

VIII. Statement of Interest

IX. Declaration