(template) Leadership and Life Skills (LLS) Training Programme (year) Registration

English Full Name (e.g. Chan Tai Man David) *

Chinese Name (e.g. 陳大文) *

Gender *

Male

Female

Age *

University Number (10 digits printed on student card) *

Undergraduate or Postgraduate Student *

Undergraduate

Postgraduate

Curriculum *

Year of Study *

e.g. year 1

Email Address (First) *

Email Address (Second)

Contact Number (First) *

Contact Number (Second)

1. Why do you want to join this programme? *

2. What do you expect to gain/achieve through this programme? *

Interview Timeslots Selection (Please select ALL your possible timeslots) *

18 Mar 2019 (Mon) ALL TIMESLOTS (10:00am-1:00pm,2:00pm-5:00pm)

18 Mar 2019 (Mon) 10:00am-10:20am

18 Mar 2019 (Mon) 10:20am-10:40am

18 Mar 2019 (Mon) 10:40am-11:00am

18 Mar 2019 (Mon) 11:00am-11:20am

18 Mar 2019 (Mon) 11:20am-11:40am

18 Mar 2019 (Mon) 11:40am-12:00am

18 Mar 2019 (Mon) 12:00pm-12:20pm

18 Mar 2019 (Mon) 12:20pm-12:40pm

18 Mar 2019 (Mon) 12:40pm-1:00pm

18 Mar 2019 (Mon) 2:00pm-2:20pm

18 Mar 2019 (Mon) 2:20pm-2:40pm

18 Mar 2019 (Mon) 2:40pm-3:00pm

18 Mar 2019 (Mon) 3:00pm-3:20pm

18 Mar 2019 (Mon) 3:20pm-3:40pm

18 Mar 2019 (Mon) 3:40pm-4:00pm

18 Mar 2019 (Mon) 4:00pm-4:20pm

18 Mar 2019 (Mon) 4:20pm-4:40pm

18 Mar 2019 (Mon) 4:40pm-5:00pm

20 Mar 2019 (Wed) ALL TIMESLOTS (2:00pm-5:00pm)

20 Mar 2019 (Wed) 2:00pm-2:20pm

20 Mar 2019 (Wed) 2:20pm-2:40pm

20 Mar 2019 (Wed) 2:40pm-3:00pm

20 Mar 2019 (Wed) 3:00pm-3:20pm

20 Mar 2019 (Wed) 3:20pm-3:40pm

20 Mar 2019 (Wed) 3:40pm-4:00pm

20 Mar 2019 (Wed) 4:00pm-4:20pm

20 Mar 2019 (Wed) 4:20pm-4:40pm

20 Mar 2019 (Wed) 4:40pm-5:00pm

21 Mar 2019 (Thu) ALL TIMESLOTS (2:00pm-5:00pm)

21 Mar 2019 (Thu) 2:00pm-2:20pm

21 Mar 2019 (Thu) 2:20pm-2:40pm

21 Mar 2019 (Thu) 2:40pm-3:00pm

21 Mar 2019 (Thu) 3:00pm-3:20pm

21 Mar 2019 (Thu) 3:20pm-3:40pm

21 Mar 2019 (Thu) 3:40pm-4:00pm

21 Mar 2019 (Thu) 4:00pm-4:20pm

21 Mar 2019 (Thu) 4:20pm-4:40pm

21 Mar 2019 (Thu) 4:40pm-5:00pm

22 Mar 2019 (Fri) ALL TIMESLOTS (10:00am-11:00am, 2:00pm-3:00pm)

22 Mar 2019 (Fri) 10:00am-10:20am

22 Mar 2019 (Fri) 10:20am-10:40am

22 Mar 2019 (Fri) 10:40am-11:00am

22 Mar 2019 (Fri) 2:00pm-2:20pm

22 Mar 2019 (Fri) 2:20pm-2:40pm

22 Mar 2019 (Fri) 2:40pm-3:00pm

25 Mar 2019 (Mon) ALL TIMESLOTS (10:00am-1:00pm, 2:00pm-5:00pm)

25 Mar 2019 (Mon) 10:00am-10:20am

25 Mar 2019 (Mon) 10:20am-10:40am

25 Mar 2019 (Mon) 10:40am-11:00am

25 Mar 2019 (Mon) 11:00am-11:20am

25 Mar 2019 (Mon) 11:20am-11:40am

25 Mar 2019 (Mon) 11:40am-12:00am

25 Mar 2019 (Mon) 12:00pm-12:20pm

25 Mar 2019 (Mon) 12:20pm-12:40pm

25 Mar 2019 (Mon) 12:40pm-1:00pm

25 Mar 2019 (Mon) 2:00pm-2:20pm

25 Mar 2019 (Mon) 2:20pm-2:40pm

25 Mar 2019 (Mon) 2:40pm-3:00pm

25 Mar 2019 (Mon) 3:00pm-3:20pm

25 Mar 2019 (Mon) 3:20pm-3:40pm

25 Mar 2019 (Mon) 3:40pm-4:00pm

25 Mar 2019 (Mon) 4:00pm-4:20pm

25 Mar 2019 (Mon) 4:20pm-4:40pm

25 Mar 2019 (Mon) 4:40pm-5:00pm

26 Mar 2019 (Tue) ALL TIMESLOTS (10:00am-1:00pm, 3:00pm-5:00pm)

26 Mar 2019 (Tue) 10:00am-10:20am

26 Mar 2019 (Tue) 10:20am-10:40am

26 Mar 2019 (Tue) 10:40am-11:00am

26 Mar 2019 (Tue) 11:00am-11:20am

26 Mar 2019 (Tue) 11:20am-11:40am

26 Mar 2019 (Tue) 11:40am-12:00am

26 Mar 2019 (Tue) 12:00pm-12:20pm

26 Mar 2019 (Tue) 12:20pm-12:40pm

26 Mar 2019 (Tue) 12:40pm-1:00pm

26 Mar 2019 (Tue) 3:00pm-3:20pm

26 Mar 2019 (Tue) 3:20pm-3:40pm

26 Mar 2019 (Tue) 3:40pm-4:00pm

26 Mar 2019 (Tue) 4:00pm-4:20pm

26 Mar 2019 (Tue) 4:20pm-4:40pm

26 Mar 2019 (Tue) 4:40pm-5:00pm

27 Mar 2019 (Wed) ALL TIMESLOTS (10:00am-11:00am)

27 Mar 2019 (Wed) 10:00am-10:20am

27 Mar 2019 (Wed) 10:20am-10:40am

27 Mar 2019 (Wed) 10:40am-11:00am

28 Mar 2019 (Thu) ALL TIMESLOTS (11:00am-1:00pm)

28 Mar 2019 (Thu) 11:00am-11:20am

28 Mar 2019 (Thu) 11:20am-11:40am

28 Mar 2019 (Thu) 11:40am-12:00am

28 Mar 2019 (Thu) 12:00pm-12:20pm

28 Mar 2019 (Thu) 12:20pm-12:40pm

28 Mar 2019 (Thu) 12:40pm-1:00pm

04 Apr 2019 (Thu) ALL TIMESLOTS (2:00pm-5:00pm)

04 Apr 2019 (Thu) 2:00pm-2:20pm

04 Apr 2019 (Thu) 2:20pm-2:40pm

04 Apr 2019 (Thu) 2:40pm-3:00pm

04 Apr 2019 (Thu) 3:00pm-3:20pm

04 Apr 2019 (Thu) 3:20pm-3:40pm

04 Apr 2019 (Thu) 3:40pm-4:00pm

04 Apr 2019 (Thu) 4:00pm-4:20pm

04 Apr 2019 (Thu) 4:20pm-4:40pm

04 Apr 2019 (Thu) 4:40pm-5:00pm

10 Apr 2019 (Wed) ALL TIMESLOTS (2:00pm-5:00pm)

10 Apr 2019 (Wed) 2:00pm-2:20pm

10 Apr 2019 (Wed) 2:20pm-2:40pm

10 Apr 2019 (Wed) 2:40pm-3:00pm

10 Apr 2019 (Wed) 3:00pm-3:20pm

10 Apr 2019 (Wed) 3:20pm-3:40pm

10 Apr 2019 (Wed) 3:40pm-4:00pm

10 Apr 2019 (Wed) 4:00pm-4:20pm

10 Apr 2019 (Wed) 4:20pm-4:40pm

10 Apr 2019 (Wed) 4:40pm-5:00pm

15 Apr 2019 (Mon) ALL TIMESLOTS (4:00pm-5:20pm)

15 Apr 2019 (Mon) 4:00pm-4:20pm

15 Apr 2019 (Mon) 4:20pm-4:40pm

15 Apr 2019 (Mon) 4:40pm-5:00pm

15 Apr 2019 (Mon) 5:00pm-5:20pm

18 Apr 2019 (Thu) ALL TIMESLOTS (3:00pm-5:20pm)

18 Apr 2019 (Thu) 3:00pm-3:20pm

18 Apr 2019 (Thu) 3:20pm-3:40pm

18 Apr 2019 (Thu) 3:40pm-4:00pm

18 Apr 2019 (Thu) 4:00pm-4:20pm

18 Apr 2019 (Thu) 4:20pm-4:40pm

18 Apr 2019 (Thu) 4:40pm-5:00pm

18 Apr 2019 (Thu) 5:00pm-5:20pm

19 Apr 2019 (Thu) onwards – interview timeslot will be confirmed by phone

I have read and confirmed that: *

*Note 1: You will pay the programme fee ($800) after your admission is confirmed. Our staff will contact you for the arrangement for your interview after receiving your application form.

*Note 2: Please note that this programme is subsidized by the University. To avoid wasting university resources, 100% attendance is required. If you fail to attend any part of the programme, your course fee for that part will NOT be returned.

Enquiries: 3917-8388 / cedars-cope@hku.hk