THE BUDDHA-DHARMA CENTRE For Internal Use Only OF HONG KONG LTD Ref. No.: Application Form for Admission to Admission Year:

Master of Arts Degree in Buddhist App. No: Studies (University of Kelaniya) Date Rec'd(dd/mm/yyyy):

1. Degree and Candidature

Degree applied for Master of Arts in Buddhist Studies Mode of study Full-time / Part-time*

2. Personal Information

Title Ven./ Mr./ Miss./ Ms./ Mrs./ Dr. * First (if any) Dharma name (if any) Gender Male/ Female * HK Identity Card No. (if any) Passport No.* Passport issuing country Date of birth: (dd/mm/yyyy) Nationality Country of birth

Correspondence address

Telephone No. ( ) E-mail address Do you require a visa to study Y/ N* in Hong Kong?

*Delete as appropriate.

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3. Education

3.1 Current Academic Studies

Title of Degree Ph.D./Master/Bachelor/Others*, please specify

Mode of Study Full-time/ Part-time* Degree Major subject

Year(s) of Study Institution Country Expected Date of Completion Grade obtained (Latest result) Language of instruction

3.2 Qualifications Obtained (Please submit certified official certificates and official transcripts for each of the qualifications obtained.)

(1) Title of Degree/Diploma* Major subject Mode of Study Full-time/ Part-time* Duration of Course (mm/yyyy-mm/yyyy) Honours Classification Institution Country Language of Instruction (2) Title of Degree/Diploma* Major subject Mode of Study Full-time/ Part-time* Duration of Course (mm/yyyy-mm/yyyy) Honours Classification Institution Country Language of Instruction *Delete as appropriate.

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3.2 Qualifications Obtained (Cont’d)

(3) Title of Degree/Diploma* Major subject Mode of Study Full-time/ Part-time* Duration of Course (mm/yyyy-mm/yyyy) Honours Classification Institution Country Language of Instruction (4) Title of Degree/Diploma* Major subject Mode of Study Full-time/ Part-time* Duration of Course (mm/yyyy-mm/yyyy) Honours Classification Institution Country Language of Instruction Note: Append extra sheets if needed.

4. Professional Qualifications Type of membership Awarding institution / Country Date of (mm/yyyy) (1)

(2)

(3)

(4)

Note: Append extra sheets if needed. *Delete as appropriate.

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5. Working Experience

Company Position Mode Employment (please specify country) (FT/PT) period (mm/yyyy) (1)

(2)

(3)

(4)

(5)

Note: Append extra sheets if needed.

6. Academic Referees

(1) Name Relationship Job position Institution

Tel. No. ( ) E-mail (2) Name Relationship Job position Institution

Tel. No. ( ) E-mail

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7. Funding

How do you intend to Self-finance/ Employer sponsorship/ Government finance your study? sponsorship/ Other scholarship or financial assistance* (please specify):

Name of organization financing your study *Delete as appropriate.

8. Other Information relevant to the application

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9. Declaration

I declare that the information provided in Sections 1 to 8 above are true and correct. I have read the Personal Information Collection Statement at Annex and agree to it.

Signature of Applicant Date

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Annex Personal Information Collection Statement

1. Personal information is provided by an applicant through the completion of application procedures and forms designated for various purposes, such as for admission to a programme of study, for the issuance of student registration card and for the provision of facilities or services. Data collected are used specifically for the purposes prescribed in the application forms and will serve as: (a) the basis for selection of applications; (b) evidence for verification of the applicant’s identity, examination results, academic records and other information; and (c) where applicable, as part of the applicant’s official student records. In the case of (c) above, information so incorporated into student records will be used for all purposes relating to the student’s studies as required by the relevant regulations and procedures of The Buddha-Dharma Centre of Hong Kong Ltd (BDCHK). 2. Personal data will be kept confidential and handled by BDCHK‘s staff members. BDCHK may transfer some of the data to an agent or other persons appointed to undertake some of its academic and administrative functions. 3. Under the provisions of the Personal data (Privacy) Ordinance Cap 486, you have the right to request BDCHK to ascertain whether it holds your personal data, to be given a copy, and to apply for correction of the data, if deemed incorrect. 4. Applications for access to and correction of personal data should be made in writing to the Programme Director of BDCHK and on payment of a fee.

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