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Form AS 7口 copy for AS for reporting to Immigration Department for not)*local sludents ( Mier□ copy for Pngramme Offering Dcpanmcnt/Faculty (please、 as appropriate)The Hong Kong Polytechnic University 香港理工大享
Form AS 7
口 copy for AS for reporting to Immigration Department for not)*local sludents ( Mier
□ copy for Pngramme Offering Dcpanmcnt/Faculty (please、 as appropriate)
APPLICATION FOR DEFERMENT OF STUDY
(Not Mpplkublc to RtJteiirch and PolL a ward prognimmes
administered bv SPEED)
Please read the notes overleaf before completing (his form.
NameProgramme TidePARTICULARS OF STUDENT
Name
Programme Tide
Programme
Stream
—
Student No.
Department Mode of Study *FT/PTE/SAND/PT/M1X/DL
Address
Day-time Contact Number: Email Address:
# Aiv you a non-loc^l siudent requiring student visa/|)ermi( to stay in Hong Kong ? *Yes/No
APPLICATION DETA1IS
I wish to defer my study at PolyU from Semester of the / academic year to the
end of Semester of the / academic year and to resume study in semester
of the / academic year. 1 understand that I should remain in my class until 1 receive the written approval from the Department.
Rcason(s) for application
Supporting documents *arc/arc no attached.
I -have / have net heen advised to have late assessment in (he current academic year.
Signature of Student Dale
* delete as appropriate
FOR OFFICE USE
DECISION OF FACULTY/DEPARTMENT
(please tick the appropriate hox)
Application is □ approved □ not approved
](Applicable io application from non-local studc/it only). A copy of the approval form will be sent (o (he Academic Secretariat for reporting to the Immigration Department. The result of application for deferment of study can only be confirmed upon receipt of the IMMD s approval.
Dale]The period of dcfcrmcnl of study will not be counted towards the maximum period of registration of the student. The student has been duly infoimcd of the changes of the programme requirement including tuition fee implications, if any, after the def
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