The Chinese University of Hong Kong

FACULTY MOBILITY SCHEMES 2017-18 Endorsement Form

Please attach your online application and seek endorsement from appropriate authorities. The completed endorsement form should be submitted in pdf format via email to the Office of Academic Links (c/o Ms. Olivia Kwok–Faculty Mobility Schemes; [email protected]).

1. Personal particulars Title (Mr./Ms./Dr./Prof.) & Name (Family Name/Given Name): Position: Department/Unit/Faculty:

Chinese Name: Are you tenured?  Yes  No [Please indicate the end date of the current contract (DD/MM/YY): ______] Note: In the event that there is less than a year of employment in your current contract after the proposed visit, your application should be supported by the Department/Unit Head (and an appropriate higher authority) with specification of intention of contract renewal. Please complete section 2 in this Endorsement Form. 2. Endorsement (Please complete A and B below.) (A) Recommendation by Department Chairman/Unit Head

(a) I support the application.  Yes /  No Please provide reasons:______

(b) I confirm that the applicant represents the University/Faculty/Department to establish collaborations at the institutional/faculty/ departmental level. (This affirmation is needed to support applications for the International Partnerships Development Programme.)  Yes /  No

(c) I confirm the intention to renew the contract of the applicant so that he/she will be employed by the University within a year after the proposed visit. (Please complete if the applicant has less than a year of employment at the University in his/her current contract.)  Yes /  No /  N/A

Name in Print: ______Title: ______Signature: ______Date: ______Note: Please skip this section and complete section B only if the applicant is a Department Chairman/Unit Head.

(B) Recommendation by Faculty Dean/Supervising Officer

(a) I support the application.  Yes /  No Please provide reasons:______

(b) I confirm that the applicant represents the University/Faculty/Department to establish collaborations at the institutional/faculty/ departmental level. (This affirmation is needed to support applications for the International Partnerships Development Programme.)  Yes /  No

(c) I confirm the intention to renew the contract of the applicant so that he/she will be employed by the University within a year after the proposed visit. (Please complete if the applicant has less than a year of employment at the University in his/her current contract.)  Yes /  No /  N/A

Name in Print: ______Title: ______Signature: ______Date: ______

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