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THE CHINESE UNIVERSITY OF HONG KONG RPg Graduate School

Application Form for Leave of Absence

(For Research Postgraduate Students)

Personal Information Collection Statement: 1. The personal data provided in this form will be used by the Graduate School for the purpose of processing this application. All information

provided, when no longer required, will be destroyed. 2. Information provided in this form may be transferred to other departments/ administrative units within CUHK for consideration and

granting approval, where applicable. 3. For correction of or access to the personal data after submission of this form, please contact the Graduate School at 3943 8976/ 8977 or

email to: gradschool@cuhk.edu.hk

I. PERSONAL PARTICULARS

Name: (English) ________________________________________ (Chinese) __________________________________

Student ID No.: _____________________ Year of Attendance: ___________ Study Mode: □Full-time □Part-time

Programme of Study: _______________________________________________________________________________

Division: __________________________________________ HK PhD Fellowship Scheme Awardee: □Yes □No II. DETAILS OF APPLICATION

For students receiving PGS: □ In-residence Leave with PGS From To Total: days (dd/mm/yy) (dd/mm/yy) calendar day

□ In-residence Leave with PGS relinquished From To Total: days (dd/mm/yy) (dd/mm/yy) calendar days

□ No-Pay Leave From To Total: days (dd/mm/yy) (dd/mm/yy) calendar days

For students without PGS: □ In-residence Leave From To Total: days (dd/mm/yy) (dd/mm/yy) calendar days

□ Non-academic Leave From To Total: days (dd/mm/yy) (dd/mm/yy) calendar days

Reasons (Please attach all necessary supporting documents):

Notes for Students: 1. The calculation of total number of leave days should include Sundays and Public Holidays. 2. In-residence Leave: i. The status of students who obtained approval to take In-residence Leave will remain Active, and normative study period will remain unchanged.

ii. The total In-residence Leave allowed is up to a maximum of 20% of the normative study period (i.e. 20% x normative period [no. of months] x 30 days). Under special circumstances, students may apply for In-residence Leave exceeding this ceiling, provided that the activity concerned is essential and closely related to the student’s thesis research. Strong justification and recommendation from Thesis Supervisor and Division Head must be provided to support such a request.

3. No-Pay Leave/ Non-academic Leave: i. The status of the students who obtained approval to take No-Pay leave will be Inactive, and normative study period will normally be extended by

the length of leave taken. ii. For non-local students, the Graduate School will notify the Hong Kong Immigration Department (IMMD) of the leave to be taken. Students are

reminded: • that you are not allowed to take up any unapproved employment or other studies in Hong Kong without prior approval from the Director of

Immigration; • that no extension of stay has been granted; and as a general rule, an application for extension of stay should be submitted to IMMD in person

or by an authorized representative approximately one month before the expiry of your current permitted stay. You must be in the HKSAR at the time of application and collection of endorsement.

4. For students who obtained approval to take In-residence Leave for 1 month or above, a Trip Report endorsed and duly signed by Thesis Supervisor should be submitted to the Graduate School within one month upon returning from your trip.

Signature of Student: ________________________________________ Date: __________________________________ □ Please “” as appropriate

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III. APPROVAL Recommendation by Thesis Supervisor (see Notes 1, 2 and 4) (For leave period of 2 months or more, please indicate how you would supervise the student during the leave period. Please use separate sheets if necessary.)

□ Recommended

□ Not Recommended

Comments:

Signature: Name: Date: (In block letters)

Recommendation by Division Head (see Notes 1, 2 and 4)

□ Recommended □ Not Recommended

Comments:

Signature: Name: Date: (In block letters)

Recommendation/Approval by Department Chairman (see Notes 1-4)

□ Recommended/Approved □ Not Recommended/Not Approved

Comments:

Signature: Name: Date: (In block letters)

Notes for Thesis Supervisor/Division Head/Department Chairman: 1. Some leave applications of HKPFS awardees require RGC approval. Please refer to the “Application Form for Academic/Non-Academic Leave”

available in the Manual on the Nomination and Selection Exercise of HKPFS for details. 2. For students receiving PGS who apply for leave except In-residence Leave, Division should also complete the form “Special Arrangement for Tuition

Fee (CUSIS)”available from http://www.cuhk.edu.hk/bursary/eng/public/financial_guides/student_fee/others.html#p2 and send it to DPU, Bursary within 1 month from the approval of application.

3. Department Chairman may approve applications from RPg students for taking i. In-residence Leave for up to a maximum of 20% of the normative study period (i.e. 20% x normative period [no. of months] x 30 days); OR ii No-Pay Leave for up to one year cumulatively.

4. Approval from the Dean of the Graduate School must be sought for applications exceeding the ceilings stated in Note 3 with strong justification and recommendation from Thesis Supervisor and Division Head.

Approval by Dean of the Graduate School (only applicable to applications exceeding the ceilings mentioned in Note 3 above)

□ Approved □ Not Approved

Comments:

Signature: Date:

For Graduate School use: □ Activity details correct Checked by

□ Trip Report required (for student taking In-residence Leave for 1 month or above)

□ Application accepted □ Application not accepted and return to Division on ___________________

□ Report received on __________________

□ Please “” as appropriate

Leave_RPg (11/2017)