7/28/2019 CU SCS Part Time Instructor Application Form

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A PPL ICATION FORM FOR PA RT-TIME INSTRUCTO R

Please fill in BLOCK LETTERS

Notes: The information provided will be used for the purpose of recruitment of part-time instructor with the School. It may be accessible to persons who will

process or review application matters in the School, or offices and committees at the University. Information on unsuccessful candidates will be destroyedafter the recruitment exercise.

AD007/ FEB 10

I. Personal Particu lars Name in English (Surname First)

Name in Chinese

Title *

Mr. / Miss / Ms. / Mrs./

Nationality

Date of Birth

Staff ID No. (Applicable to CUHK staff only)

( )

D D M M Y Y

HKID Card / Passport No./ ( )

Date of Issue and Country of Issue Do you have a valid working visa in Hong Kong?

? Yes No Not Applicable

Address (in English) ( )

Telephone (Home )( )

(Off ice )( )

(Mobile)( )

Fax. No.

Pager No.

Email Address

Correspondence Address (if different from above) ( )

II. Academic At tainment Date Name of College or University

Major

Minor

From To Cert / Dip / Degree

/ / Date Awarded

III. Working Experience

EXPERIENCE OTHER THAN TEACHING ( )Date Organization / Employer

/ Position Held

From To

* Please delete as appropriate Please Turn Over.

7/28/2019 CU SCS Part Time Instructor Application Form

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TEACHING EXPERIENCE Date Name of College or University

Rank or Title

Subject & Level Taught From To

Professional Memberships

IV. Specific Courses/Programmes Intended to Teach (if any) ( )

Day(s) Available * : Monday / Tuesday / Wednesday / Thursday / Friday / Saturday / Sunday

Time Available : Day-time (From a.m. / p. m.)

Evening (From p. m.)

Location(s) Preferred : Hong Kong / Kowloon / New Territories

V. Experti se (Please tick as appropri ate) ( 3 )

I. Art, Music and The Humanities

A B

1 Chinese Art Piano2 Calligraphy Guitar3 Western Art: Painting/Drawing Popular music4 3D Art: Sculpture/ceramics/glass Computer music5 Computer graphics / Multimedia Design Music theories and teaching6 2D Design: graphic/illustration/comic/printing/advertising Literature7 Applied Design: interior/fashion/jewelry/product History8 Photography/Cinema/Digital video Religious Studies9 Dance/drama and theatre Philosophy

10 Home Care & Craft Chinese poetry & classic / Chinese studies11 Fungshui Aesthetics/Art Appreciation/Architecture12 Chinese Music Cultural Studies13 Chinese Opera General Education14 Western Music Creative/Critical Thinking15 Voices & choral conducting Politics16 Musical instruments Travel & Leisure17 3D Modeling / Animation Others: ________ _________ ________ ________ ____

II. Business & Management

A B1 Accounting & Finance Management2 Banking & Insurance Marketing3 Economics Public Administration4 China Business Hospitality, Tourism & Service Management5 Law Recreation & Leisure6 Others: ________ _________ ________ ________ ____

Please delete as appropriate

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V. Traditi onal Chinese Medici ne & Health Care

A B

1 Traditional Chinese Medicine Nursing & Education2 Tui-na Rehabilitation Science3 Chinese Kung Fu Nutrition Education4 Complementary Therapy Pharmaceutics Education5 Gerontology Education Others: ________ _________ ________ ________ ____

VI. Social Sciences, Discipl inary Forces & Security Stud ies

A B

1 Disciplinary Forces & Security Studies Management2 Social Sciences Psychology & Counseling3 Anthropology Adventure Tourism4 Early Childhood Education Culture Tourism5 Education for the Elderly Social Work6 Adult Education Sociology7 School Education Womens Development8 Employment Schema Mass Communication9 Government & Administration Philosophy10 Library & Information Other: _________ ________ _________ ________ ___

VI. Are you currently a ful l-time post-graduate student of CUHK?

Yes

Student ID : Programme :Study Year : Department :

Expected Year of Graduation : _________ ____

Receiving studentship ? Yes No (Note: Post-graduate students receiving studentship and the like from the University may, with the approval of Faculty Dean, take uppart-time teaching engagements up to the number of working hours per academic year at the pay-rate as set out by the University.)( )

No

I am not a full-time post-graduate student of CUHK currently. I understand that its my responsibility to inform the School of Continuing &Professional Studies immediately should I become a full-time post-graduate student of CUHK and my pay-rate may be adjusted accordingly.

Signature : Date :

VI. Declaration

I declare that the information given by me is correct and complete to the best of my knowledge. I understand that if I knowingly supply falseinformation or withhold any material information, The Chinese University of Hong Kong shall have the right to rescind any verbal/written offer of appointment and I shall render myself liable to dismissal if I am eventually appointed by the University.

Date Signature

Completed application form together with photocopies of HKID Card, academic results and professional membership certificates should be sentto: School of Continuing & Professional Studies, The Chinese University of Hong Kong, Shatin, N.T. Hong Kong. (Attn.: Administration Section Personnel)

( )

FOR OFFICE USE ONLY

Name of Bank and Branch Address

Account Number

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