Scholarship for Prospective English Teachers (2022/23)Application Form

Annex 3 (附件三) (Office Use Only) Application No.:

Scholarship for Prospective English Teachers (2022/23) Application Form

(a) The Application Form is available on the

website of the Education Bureau (http://www.edb.gov.hk/scholarship)

(b) Read the Information Sheet (Annex 2) carefully before completing this form.

(c) Complete the form in BLOCK letters and in black ink.

(d) Complete all relevant parts in the form accurately. If there is insufficient space, use a separate sheet and attach it to the application form. You are advised to keep a photocopy of the completed application form for your own reference.

(e) Your provision of all the personal data requested in this form is obligatory, except those items clearly marked as optional. Your application may not be processed if you fail to provide all information as required.

(f) The application period is from 10 to 19 August 2022. The completed form, together with all supporting documents, should be submitted by post or in person to:

Language Teacher Qualifications Team

Professional Development and Training Division, Education Bureau Room 1107, 11/F, Wu Chung House

213 Queen’s Road East, Wanchai, Hong Kong

(g) Mark clearly on the envelope “Application for the Scholarship for Prospective English Teachers (2022/23)”. An acknowledgement email will be sent to the applicant upon receipt of application.

(h) Applicants should also make arrangements for the Recommendation Form to be completed and sent to the Education Bureau at the address in (f) above by the deadline. Otherwise, the applications may not be processed and the applicants concerned will not be shortlisted for the selection interviews even if they have met the shortlisting criteria.

(i) Late application will not be accepted. For application submitted by post, please ensure that sufficient postage is paid to avoid unsuccessful delivery of application.

(j) For enquiries about the Scholarship for Prospective English Teachers (2022/23), please send an email to ltq@edb.gov.hk or contact Ms Constance CHOW (Tel. 852-2892 5786) of the Professional Development and Training Division, Education Bureau.

Section A Personal Particulars

Name in English (Surname) (Other Names)

Name in Chinese

(if applicable) Chinese Name in Chinese

Commercial Code (if applicable) Date of Birth ____ / ____ / ______ (dd/mm/yyyy) Place of Birth

Sex^# □ Male □ Female Nationality

Hong Kong Identity Card No.

(Please submit a copy of your Hong Kong Identity Card)

Do you need a student visa / an entry permit for the purpose of study in Hong Kong?^# □ Yes □ _No

If yes, please provide the following information related to your Passport / Travel Document and submit a copy of your Passport / Travel Document.

Passport / Travel

Document No. Issuing Authority for Passport /

Travel Document

Date of Issue Date of Expiry

#Please tick as appropriate.

____ / ____ / ______(dd/mm/yyyy) ____ / ____ / ______(dd/mm/yyyy)

Annex 3 (附件三)

Section A Personal Particulars (Cont’d)

Permanent Address (a residential address in home country or normal place of residence)

Correspondence Address in Hong Kong

(if different from the address given above)

Contact Telephone No.^@ Residential Telephone

No.^@ (optional) Email Address^@

@ Applicants who are currently residing in Hong Kong should enter their telephone nos. in Hong Kong. Non-local applicants who are currently residing outside Hong Kong should provide the telephone nos. in their home country / normal place of residence. A direct contact telephone no. in Hong Kong should be provided if they have one.

Applicants should also ensure that they can be reached via email, after the application has been submitted.

Section B Academic Attainment and Record of Participation in Activities and/or Services

Public Examination Issuing Authority Date Issued

(Month/Year) All Subjects Passed and Grade/Level Attained

(Please submit copies of result slips or certificates.)

II. Results of IELTS and TOEFL

Examination/Test Date Issued (dd/mm/yyyy) Result(s) Attained

(Please submit a copy of the Test Report Form / Score Report.)

Annex 3 (附件三)

III. Record of participation in activities/services in Senior Secondary School and/or Higher Education Institution

School Year Name of Activities/Services Award/Achievement/Post Name of Organisation

Section C Education

I. Study programmes attended

School(s), College(s), Higher Education

Institution(s), etc. Attended Class Attended Qualification Obtained Date (month/year)

From To

(Please submit a copy (copies) of graduation certificate(s).)

II. Study programme to pursue in the 2022/23 school year

Name of Higher Education

Institution Title of Programme Major Subject Year of Study Specialisation^#

□ Year 1* □ Primary

□ Secondary

□ Not Specified

* Only applicants who will pursue year one study are eligible to apply for the Scholarship.

#Please tick as appropriate.

 Please submit a copy of offer letter / supporting document to prove that you have been admitted by the higher education institution.

 For applicants who will start pursuing PGDE programmes, please submit a copy (copies) of transcript(s) / certificate(s) of their Bachelor degree(s).

Annex 3 (附件三)

III. Full employment record in school(s) to date (for PGDE applicants only)

Name of School(s) Position Held Nature of Work Date (Month/Year)

From To

Section D Supporting Information

Give a brief account of your aspirations for a career as a teacher of English.

II. Recommendation Form

You will need to make arrangements for the Recommendation Form to be completed and returned to the Education Bureau. The Recommendation Form should be completed by the Principal or a teacher of the secondary school you attended or by a member of the academic staff of the higher education institution you attended, who should then return the completed form to the Education Bureau on or before 19 August 2022. Otherwise, the application may not be processed and you will not be shortlisted for the selection interviews even if you have met the shortlisting criteria.

Annex 3 (附件三)

Section E Declaration

I declare that all the information provided in this form is accurate and true. I understand that if I willfully give any false information or withhold any material information in this application form, or fail to notify the office concerned of any subsequent change of information provided, it will render me liable to disqualification for selection for the Scholarship for Prospective English Teachers (2022/23). If the Scholarship has already been awarded to me, it may be terminated and I may be required to reimburse the scholarship monies received. I understand that my application should be supported by relevant documents/evidence. If I fail to do so, my application may not be processed.

I consent to the HKSAR Government making any necessary enquiries as required in matters relating to the Scholarship and for the verification of the information given in my application. I understand that the personal data provided in the application form will be provided to the Student Finance Office, Working Family and Student Financial Assistance Agency for purposes relating to the award of the Scholarship for Prospective English Teachers (2022/23) if my application is successful.

Signature of Applicant: Date:

Name of Applicant: _______________________________

Annex 3 (附件三)

Section F Checklist

Check that you have: (Put a tick in the appropriate boxes.) Office use only

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Office use only

Requirements fulfilled:

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Shortlisted:

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