Form AS 4 Faculty of ______

APPLICATION FOR TESTIMONIAL (Not applicable to Research programmes and PolyU award programmes administered by SPEED)

Please read the information overleaf before completing this form.

I. PARTICULARS OF APPLICANT Name (*Mr/Miss/Mrs/Ms) / (in English) (in Chinese, if applicable)

HKID Card/Passport/ Student No. Mainland ID No. ( )

Address

Email: Contact Phone No.

II. PROGRAMME(S) OF STUDY

1. Programme Title Code Year Admitted Year of last attendance

2. Programme Title Code Year Admitted Year of last attendance

Date Signature of Applicant

III. FOR OFFICE USE ONLY

Application received by Date

* Delete as appropriate

(21 Sept 2015) Form AS 4 Faculty of ______Points to Note before Completing the Form

1. Applicants should complete ONE form for each Faculty/School of Design (SD)/School of Hotel & Tourism Management (SHTM) and return it to the Service Centre of the Academic Secretariat at Room M101, Li Ka Shing Tower or to the relevant Faculty Office/SD/SHTM for processing through the following means:

BY EMAIL By fax OFFICE BY MAIL ENQUIRY (ONLY for applications which the TEL payment are settled by on-line credit card system) EPH

ONE

NO. Faculty of Applied Science & Textiles (FAST) [email protected] 2362 2578 The Hong Kong Polytechnic University 2766 5057 Faculty of Business (FB) [email protected] 2362 5773 Hung Hom 2766 5084 Faculty of Construction and Environment (FCE) [email protected] 2362 2574 Kowloon 3400 8496 Faculty of Engineering (FENG) [email protected] 2176 4563 Hong Kong 2766 5064 Faculty of Health & Social Sciences (FHSS) [email protected] 2363 0146 Attn: ( please state the name of the 2766 5077 relevant Faculty Office/SD/SHTM) Faculty of Humanities (FH) [email protected] 2363 8955 3400 8212 School of Design (SD) [email protected] 2333 8812 3400 3987 School of Hotel & Tourism Management (SHTM) [email protected] 2362 9362 3400 2200

This form is not applicable to Research programmes and PolyU award programmes administered by SPEED. Please visit the website of Research Office (http://www.polyu.edu.hk/ro/) or SPEED (http://www.speed-polyu.edu.hk/) for the application procedures on testimonials for these programmes.

2. You are required to enclose a copy of your HKID (or Passport/Mainland ID for those without HKID card) together with the completed application form.

3. You can present your HKID card (or Passport/Mainland ID for those without HKID card) and collect your testimonial in person from the Service Centre. If you authorise another person to collect the testimonial on your behalf, please also provide a letter of authorisation along with the application, stating the name and HKID card no. (or Passport no. for those without an HKID card) of the authorised person. A copy of your HKID card and the authorised person’s HKID card (or Passport for those without an HKID card) will be required for verification. Your HKID/Passport copy will be destroyed after your application has been processed.

4. For current students, testimonial will normally be ready in 7 working days while for other students/graduates, the Faculty Office/SD/SHTM may need more time to process your applications. Please note that if your testimonial is not collected within 3 months from the date of issue, it will be destroyed for security reason.

(21 Sept 2015)