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.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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 :  ________________________________

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Privacy Policy Statement and Personal Information Collection Statement (PPS/PICS)
 
According to the Privacy Policy Statement / Personal Information Collection Statement (PPS/PICS) of the Hong Kong Baptist University (the "University"), personal data of students of the University are collected and retained for a variety of reasons and used for many purposes as such have been set out in the PPS/PICS. Please visit https://www.hkbu.edu.hk/eng/about/privacy.jsp for access to the PPS/PICS.
 
Under the provision of the Personal Data (Privacy) Ordinance, request for personal data access or correction may be made and addressed to:

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