Exemption of Compulsory Residence 2017

Exemption of Compulsory Residence 2017

Exemption Period January – June 2017
Application deadline: November 7, 2016  NOW CLOSED [late application will not be considered]

Exemption Period July – December 2017
Application deadline: April 30, 2017 NOW CLOSED [late application will not be considered]

This form is designated for MBBS students, who undertake Specialty Clerkships in 2017, to apply exemption of Compulsory Residence. For details, please refer to document M143/916 sent by the Faculty Office dated October 11, 2016.

*Required field

Part I - Personal Particulars

UID*

Name in English*

Name in Chinese (if applicable)

HKU Email*

Contact number*

Group of Specialty Clerkship*
1234567


Part II – Exemption Details

Exemption period (from)*

Exemption period (until)*

Exempted Specialty Clerkship(s)*
MedicineSurgeryO&GPaed

Reason (corresponding supporting document must be attached)*
Residing in the area between Centre Street and University HallResiding in another University-administrated HallSpecial Education NeedsOther Reason

Remarks made by applicant


Part III – Attachment (Max 1MB for each file in pdf format)

Major supporting document (eg: address proof, medical recommendation letter, department reference letter etc)*

Other supporting document (i)

Other supporting document (ii)


Part IV – Declaration

*I declare that the information given in support of this application is accurate and complete. I understand that any misrepresentation will disqualify my application and any false information may lead to filling of misconduct in students’ personal file and/ or referral to Disciplinary Committee.