GRADUATE SCHOOL
Application for Replacement of Student Card 

(1)	Students who have to apply for replacement of a student card should fill in Section I of the application form.
(2)	Students will be issued a debit note and are required to pay a replacement fee of HK$100 at the Campus Branch of the Hang Seng Bank.  The copy of the payment slip should be returned to the Graduate School.
(3)	New student card will be issued immediately upon receipt of the payment slip.
(4)	Students who apply for replacement of student card for reasons other than loss of card have to surrender their old card to the Graduate School once the new card is issued.
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Section I: To be Filled in by Applicant

Name :  _________________________________________	Student No : ___________________________

Programme/Major :  _______________________________	Contact Tel No : ________________________

	I would like to apply for a new Student Card owing to the following reasons (Please check the appropriate box):
			
		I have lost my student card.
��	I have changed my name.  My new name should be _________________________________________
��	My student card is torn and damaged.			
		I have changed my programme/department. The new programme/department should be ___________________.  (No replacement fee is required)
��	The expiry date/study mode* of my student card has to be adjusted.  The expiry date date/study mode* should be ________________________ (No replacement fee is required)
��	The chip/barcode* of my card malfunctions. (No replacement fee is required) 
		
Applicant’s Signature :  _____________________________	Date :  ________________________________

Declaration by students who have lost their student cards:
I, ___________________________ , hereby declare that I have lost my student card.  I fully understand that I will be held responsible for any illegal use of my lost card.

Signature :  ____________________________________	Date :  _____________________

Section II: For Office Use Only

Application & Replacement fee received on: _________________ by _____________________
SIS Record checked by: ___________________
Current Barcode: Z____________		New Barcode: Z____________
New Student Card Issued on ___________ by ___________	Old Card Collected & Disposed: _____________

Section III: To be completed upon collection of New Student Card by Student

Signature :  _________________________________ 	Date :  ________________________________

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Personal Data (Privacy) Ordinance
Personal Information Collection Statement
Persons who supply personal data in their applications to the Graduate School for various purposes are requested to note the following:

1.	Personal data provided in the applications are to facilitate the process of their applications and will not be used for other purposes.
2.	Personal data provided will only be used by University staff.
3.	After the applications have been processed, relevant data will be transferred to the student record system of the University. 

Under the provision of the Personal Data (Privacy) Ordinance, request for personal data access or correction may be made and addressed to:

			Graduate School
			AAB 904, Level 9, Academic and Administration Building,
			Baptist University Road Campus,
			Hong Kong Baptist University
			Kowloon Tong
			Kowloon