PDF《 Course code 1:》

E-LP (07/17) 填写本表格前, 请先参阅「重要事项」.

Please read the Important Notes before completing this Form. 语文能力考试申请表 APPLICATION FOR LANGUAGE PROFICIENCY EXAMINATIONS 个人资料 STUDENT PERSONAL PARTICULARS 姓名(*先生/女士) Name (*Mr/Ms): 英文(English) 中文(Chinese) 学生编号或身份证号码* Student No. or HKID No.* : 电话 Tel.: 住宅(Home) 办公室(Office) 内线(Ext.) 流动电话/传呼机(Mobile phone/Pager) 传真机号码(Fax) 地址(如与校方纪录有异) Address (if different from the record of the University): 拟报考科目 EXAMINATIONS TO APPLY FOR 填写此表格时,请参阅刊载於本校网站的考试时间表. Please refer to the examination timetable posted at the OUHK website for details in filling out this form: 考试期 Exam Period: 科目编号

(一) ? Course code 1: 科目编号

(二) ? Course code 2: 科目编号

(三) ?Course code 3: 科目编号

(四) ?Course code 4: 你曾否参加上述语文能力考试或在香港公开大学修读上述科目? 是否Have you attended the above Language Proficiency Examination(s) or studied the above course(s) with the OUHK previously? ? ? Yes No 若是,请列明有关科目编号 If Yes, please indicate the respective Course Code(s): 费用 PAYMENT 兹连同本表格缴交每科港币壹仟元正*划线支票/银行本票,号码为 ,抬头人为 香港公开大学 ,作为参加上述语文 能力考试之考试费.本人明白并同意上述费用概不退还,除非上述申请未获接纳. I have enclosed with this request a *crossed cheque/bank cashier order number of HK$1,000 per course payable to The Open University of Hong Kong to cover the examination fee for the Language Proficiency Examinations indicated herein. I understand that the fee will not be refunded unless the above application is not accepted by the University. 学生签署 日期 Signature of Student: Date: * 请删去不适用者 转下页 * Please delete as appropriate P.T.O. E-LP (07/17) 重要事项 IMPORTANT NOTES

1 你在此表格所提供的个人资料会用作一切学生及大学的行政管理用途.若你未能提供完整及准确的资料,大学可能无法提供你所需的学术及行政 管理服务.大学会将你所提供的资料保密,但亦可能将资料交予大学有关人员及为大学提供服务的其他人员及机构.你有权查阅及改正你的个人 资料,如有需要,请联络教务处考试组 (兼读制课程及研究生课程) 或保障资料主任. The personal data provided on this form will be used for student and University administration purposes. Failure to provide complete and accurate information may affect the provision of academic and administrative services to you. The University will keep the personal data provided confidential but may need to disclose it to appropriate personnel in the University and other parties providing academic and administrative services to the University. You have the right to request access to and correction of your personal data. If you wish to do so, please contact the Examinations Office (Part-time &

Postgraduate), Registry, or the Data Protection Officer.

2 倘若你希望测试自己的语文能力,你可选择不注册修读有关的语文进阶科目,而只参加期终考试.考试及格会获颁证书,但不可取得学分.有兴 趣人士,请填妥 E-LP 表格,连同每科港币壹仟元正的考试费的划线支票在限期前(请参阅刊载於本校网站的截止提交日期),寄交九龙何文田牧爱 街三十号五楼 A0511 室香港公开大学教务处考试组 (兼读制课程及研究生课程).逾期申请,恕不受理. Anyone interested may apply to attend the end-of-course examination of the Language Enhancement Courses offered by the University to assess his/her language ability. Application can be made by submitting a completed Form E-LP, together with a crossed cheque of HK$1,000 per course before the deadline to cover the examination fee to the Examinations Office (Part-time &