个人资料更改通知书
Personal Data Amendment Form
Notes : Personal Data Collection Statement The Personal data provided in this form will be used by the School of Continuing Studies for purposes
relating to the processing of your enrollment / your studies only.
注意:个人资料收集声明 阁下在本表上所提供的个人资料,本院祗用作处理 阁下所报读 / 修读课程的有关事宜.
Please fill in this form and send to School of Continuing Studies at "Inter-University Hall, The Chinese University of Hong Kong, Shatin, Hong Kong"or
fax to 2603 6565.
阁下如有需要修改或更正个人资料,请填写此表,寄回 「新界沙田香港中文大学博文苑中大校外进修学院」 或传真至 2603 6565.
Name in EnglishName in Chinese
英文姓名中文姓名
H.K.I.D. Number / Passport no.Student I.D. (if applicable)
身份证号码/ 护照号码学员编号 ( 如适用 )
Courses / Programmes being studied or enrolled (Please list all programme names with cycle numbers and
codes, if any)
现正修读或已报名之课程( 如适用,请列出所有课程科目,届别及编号)
Amendment 更改资料(Please tick the relevant item and fill in the updated information 请选择更改之项目及提供有关资料)
Office Use Only 本院职员专用
Handled by 经手人______________________________Date 日期____________________________________
Filed by 存档___________________________________Date 日期____________________________________
Name 名字
(Please enclose copy of supporting document if you have changed your
name on the I.D Card)
(若学员更改身份证上之姓名,请提供有关证明文件之影印本)
Old Name
旧姓名
New Name
新姓名
Mailing Address 邮寄地址
E-mail Address 电邮
Fax Number 传真号码
Contact Number 联络电话
Home Number
住宅号码
Student's Signature_______________________________Date_____________________________________
学员签署日期
(English)
(中 文)
(English)
(中 文)
Office Number
辨事处号码

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