Form AS 118: Please Delete Where Inappropriate

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Form AS 118

APPLICATION FOR REINSTATEMENT OF REGISTRATION


Please read the notes overleaf before completing this form.
I. PARTICULARS OF STUDENT
Name ___________________________________________

Student No.
Programme

Programme Title _____________________________________________

Stream
_

Department
Day-time Contact Number
II. REASON FOR APPLYING FOR REINSTATEMENT OF REGISTRATION
Please tick as appropriate :
(1)

Had not settled tuition fee after the deferred payment date

(2)

Had not settled tuition fee/fee for retention of study place for the new semester/academic year by the
payment deadline

(3)

Had not settled fee for subject adjustment by the payment deadline

(4)

Had not settled fee for withdrawal of subject by the payment deadline

(5)

Had not completed subject registration/applied for zero subject enrolment by deadline

(6)

Tuition fee paid by cheque/PPS/Internet Banking Bill Payment Service/ATM was rejected by the bank

Signature of Student
Date
----------------------------------------------------------------------------------------------------------------------------------------------FOR OFFICE USE
Decision of Programme Offering Faculty/Department
I (*Faculty/Department) *approve/disapprove the student to have his/her *student status/withdrawn subject record reinstated
in Semester ____________ of the __________________/__________________ academic year.
(* Please delete where inappropriate)
Signature of DELO/Officer in charge

Department

Name in Block Letters

Date

Action Taken, if any (Please tick as appropriate)


By Programme Offering Faculty/Department
Approved application sent to FO and AS by ___________________________ on ___________________________
Fee related matters has been advised by FO __________________________ _ on ___________________________
Student has been advised by ___________________ on _______________ to settle the payment and inform AS after
fee payment.
Student status has been updated by AS to "Active" on _________________
Subject registration record for student has been updated by ____________________ on _________________
(4/2013)

Form AS 118
NOTES TO STUDENTS
1. Application for reinstatement of registration should be submitted within 2 weeks from the date
of nullification of registration on programme/subject and will only be considered under
exceptional circumstances. Completed form should be returned to the Programme Offering
Faculty/Department. Student will be advised of his/her application result within 7 days after
submission of application by the Programme Offering Faculty/Department.
2. For approved case, a reinstatement fee of HK$400 will be charged.
3. Please note that the information given in the form will only be used for processing this
application.

(4/2013)

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