Personal Particulars Kwok Cheuk Yan Name in English () (Surname first): Name in Chinese:

Passport/Travel Document Number: Flat K, floor 23, block 2, Correspondence Serene Garden, Tsing Yi Address: New Territories D - Yau Tsim Mong, Sham Shui Po, Tsing Yi, Kwai District Code: Chung and Tsuen Wan Hong Kong Name of region/country: 6095 3040 Daytime Contact Telephone Number / Mobile Phone Number: kwokmouse@yahoo.com.hk E-mail Address: Highest Academic Qualification / Professional Qualification / / I have attained a bachelors degree / masters degree / doctorate or equivalent. 2010-11 I will have attained a bachelors degree or equivalent in the 2010-11 academic year. ( )

Male Hong Kong Sex Identity Card : Number: Issuing Authority:

Z 357456(4)

I possess a qualification meeting the entry requirement on professional qualifications required for civil service degree or professional posts. (Only applicable to those who are not in the above two categories.)

Best Results in Public Examinations Hong Kong Advanced Level Examination (i) / D / Chinese Language and Culture / Chinese Language and Literature: (ii) D Use of English : General Certificate of Education (Advanced Level) (i) English Language: X Choice of Examination Papers ( C ) Use of (Not applicable to applicants with Grade C or Chinese above in any of the above Chinese Language subjects) ( C ) Use of (Not applicable to applicants with Grade C or English above in any of the above English Language subjects) Aptitude Test Basic Law Test () For applicants with a disability (Optional) If you are an applicant with a disability and require special arrangements for attending the examination, please state the arrangements required and indicate the nature and degree of disability. Applicants may be required to produce medical proof of their disability. If no special arrangements are required, you need not fill in this section. :

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Supplementary Information (Optional) 1. () Please indicate the major of the highest academic qualification that you have attained / will have attained according to the codes of the academic disciplines at List 1. (If you take double major, please fill in only one of them according to your preference.): 2. If you have attempted any of the following examinations, please indicate the grade(s) that you have obtained. (A) IELTS : Score bands of the IELTS (Academic Module): Overall score: Listening: Speaking: Reading: Writing: (B) : Hong Kong Certificate of Education Examination : D Chinese Language: () English Language (Syllabus A): () D English Language (Syllabus B): (C) General Certificate of Education (Ordinary Level) / General Certificate of Secondary Education: English Language / English: (D) General Certificate of Education (Advanced Level): Chinese: