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REG Form 19a_Authorisation Form (UG,PG)

This document is an Authorisation Form for applicants who wish to authorize a representative to collect personal documents on their behalf. It outlines the requirements for the representative, including necessary identification and the applicant's obligations regarding outstanding fees. The form also includes sections for personal particulars, authorization details, and a declaration by the applicant.

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w.chakhang
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4 views

REG Form 19a_Authorisation Form (UG,PG)

This document is an Authorisation Form for applicants who wish to authorize a representative to collect personal documents on their behalf. It outlines the requirements for the representative, including necessary identification and the applicant's obligations regarding outstanding fees. The form also includes sections for personal particulars, authorization details, and a declaration by the applicant.

Uploaded by

w.chakhang
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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For Office Use Only

Received on:
Ref. No.

Authorisation Form (UG/PG)

Notes for Applicants:


1. Applicants who are unable to collect their personal document(s)/item(s) (e.g. graduation certificate, academic transcript,
graduation photo, etc.) in person may authorise a representative to collect it/them on their behalf.
2. The authorised representative is required to present this authorisation form (completed and signed by the applicant),
original/copy of the applicant’s HKID or Student Card, and the HKID of the authorised representative. Digital Copy is also
acceptable.
3. The University bears no responsibility for any loss or damage of the document(s)/item(s) collected by the authorised
representative.
4. Applicants are required to settle all outstanding fees before collecting the graduation certificate or other academic documents.
The University reserves the right to withhold the issuance of academic certification to a graduate who has unsettled matters
with the University.
5. For details of the Personal Information Collection Statement, please refer to http://registry.hsu.edu.hk/.

Part 1: PERSONAL PARTICULARS


Name (in English): (in Chinese):

Student No.: HKID No.:

Contact No.(Mobile): Email Address:


Programme
(and Concentration, if any):

Part 2: AUTHORISATION STATEMENT

I hereby authorise the following person to collect the following item(s) on my behalf:

Item(s) to collect:

Name of authorised representative:

HKID No. of authorised representative:

Part 3: DECLARATION

I have carefully read, understood and agreed with the Notes for Applicants.

Signature of Applicant Date

REG-UG/PG Form 19a (Rev. 08/2020) Page 1 of 1

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