The Chinese University of Hong Kong s4

The Chinese University of Hong Kong

International World’s Challenge Challenge 2018 Application Form

Completed application form should be submitted to the Office of Academic Links (OAL) c/o Ms. Cora Chan. Please note that: .The information provided herein will be used by the OAL for determining the eligibility for application. .All fields in the application form must be filled. If the item(s) is/are not applicable, “N.A.” should be marked. .A 3-minute video presentation should be submitted with the application form. .Applicants may be required to provide supporting documentation in respect of information given in their applications. .Incomplete application would not be processed.

I. Personal Information

Ia. Team Member 1 - Personal Particulars (Main contact person)

Title (Mr/Ms) and Name (Family Name/Given Name): CUID Number:

Study Programme: Year of UG/PG: Department/Division: Attendance:

Mailing Address: Contact Phone Number: Email:

Ib. Team Member 2 - Personal Particulars Title (Mr/Ms) and Name (Family Name/Given Name): CUID Number:

Ic. Team Member 3 - Personal Particulars Title (Mr/Ms) and Name (Family Name/Given Name): CUID Number:

II. Information of Project/Activity

Name of Project/Activity: Host Organizer(s):  ______College  Faculty/School/Department of ______ Other CUHK Unit (Please specify):______ Other Organization (Please specify):______

Brief Project Description:

Period (DD/MM/YY): Location (Please list the city/cities your project/activity will be conducted):

______to ______No. of Participant(s): Type of Audience: No. of Audience:

Name of Advisor: Position: Department:

Contact Phone Number: Email:

What global challenge will your team address? Sustainable Development Goals: □ 1. To end poverty in all its forms everywhere □ 2. To end hunger, achieve food security and improved nutrition and promote sustainable agriculture □ 3. To ensure healthy lives and promote well-being for all at all ages □ 4. To ensure inclusive and equitable quality education and promote lifelong learning opportunities for all □ 5. To achieve gender equality and empower all women and girls □ 6. To ensure availability and sustainable management of water and sanitation for all □ 7. To ensure access to affordable, reliable, sustainable and modern energy for all □ 8. To promote sustained, inclusive and sustainable economic growth, full and productive employment and decent work for all □ 9. To build resilient infrastructure, promote inclusive and sustainable industrialization and foster innovation □ 10. To reduce inequality within and among countries □ 11. To make cities and human settlements inclusive, safe, resilient and sustainable □ 12. To ensure sustainable consumption and production patterns □ 13. To take urgent action to combat climate change and its impacts □ 14. To conserve and sustainably use the oceans, seas and marine resources for sustainable development □ 15. To protect, restore and promote sustainable use of terrestrial ecosystems, sustainably manage forests, combat desertification, and halt and reverse land degradation and halt biodiversity loss □ 16. To promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels □ 17. To strengthen the means of implementation and revitalize the global partnership for sustainable development Describe the global challenge and explain why your group is interested in it, and why it is important to work toward a resolution? (Approximately 300 words)

II. Information of Project/Activity (Cont’d)

Provide a brief outline of your team’s idea/project to address the chosen global challenge. (Approximately 400 to 800 words) How did you find out about the World’s Challenge Challenge? □ 1. Email □ 2. Website □ 3. World’s Challenge Challenger Poster □ 4. Social Media □ 5. Office of Academic Links □ 6. My Professor □ 7. Another Student □ 8. Other

To prepare your presentation, please visit the World’s Challenge Challenge website at http://www.worldschallengechallenge.com/ where you can download the scoring rubric. Good luck! III. Declaration by Applicants

We declare that the statements made and information given in this application are, to the best of our knowledge, true, complete, and correct. We are aware that the University will rely on the information provided by us to determine our eligibility. We understand that (1) any omission/misrepresentation of information with a view to obtaining pecuniary advantage by deception is an offence and is liable to legal proceeding(s); and (2) incomplete applications will not be processed. We also understand that if the application is successful, the reimbursement report, written report and a video presentation are required to be submitted within one month after the completion of the project, otherwise no reimbursement will be made. We authorize the University to obtain any further information from, and disclose the information provided in this application to the appropriate bodies for the purpose of processing my application or verifying information provided in this application.

Signature of Team Member 1: ______Date: ______(Name: )