Notification for Withdrawal of Study

Hong Kong Institute of Vocational Education (Tsing Yi)
Notification for Withdrawal of Study
Please read the “Notes to Students” overleaf before completing this form.
I(A). Particulars of Student
Name （English）: *Mr／Ms
（Chinese）:
Student No／HKID No:
Date of Birth :
Address :
Telephone : (Home)
(Mobile)
I(B). Particulars of Course
Course Title :
Course Code :
Year : 20
Offering Department :
 AE
to 20
 BA
 CN
Mode :
 FT
 ENG
 ICT
 PTD
 PTE
 MSTI
I(C). I have decided to withdraw my study from the course mentioned in I(B) above due to the reason of code (________)
(see Note 3 overleaf for the reason code.). My last attendance date is ___________
(Date).

My Student Card is attached and returned to
IVE(Tsing Yi).
I hereby declare that I have lost my Student
Card. (See Note 2 overleaf.)

 Please send the Transcript of Study to me by post
(See Note 4 and 6 overleaf.)
 I will collect the Transcript of Study in person
(See Note 5 and 6 overleaf.)
Signature of Student :
Date :
To be endorsed by Parent/Guardian if the student is aged below 18:
Name of Parent/Guardian :
Signature of Parent/Guardian :
II.
Date :
Serial No:
FOR CAMPUS SECRETARIAT USE ONLY


















/
D/R on
*before／after BoE due to *student’s request／Dept’s Notification.
Present result in BoE. *Yes.／No. Confirmed with Dept on
.
Last Attendance Date in MSRP1103M updated on
.
Tuition Fee (T.F.) Calculation in MSMP05104M.
Void Payment Advices in MSMP05127M.
*Adjusted Required T. F. in MSRP5104M／Student Ledger MSMP05613Q on
.
Defer payment approval $
. (Due date:
)
Student Card *surrendered／declared lost／did not return by student／returned to CS by Dept.
Eligible for *FD／C／D Exit Award. *N.A.／No.／Yes, changed to Exit Award on
.
*Outstanding T.F. of $
／to refund overpaid T.F. of $
.
Outstanding reassessment fee of $
.
*Outstanding BMF of $
／Overpaid BMF of $
*to be refunded／to offset outstanding T.F.
Outstanding Library loans of $
.
Caution Money of $
*to be refunded／forfeited due to unofficial withdraw.
Notification copied to *AE／BA／CN／ENG／ICT／MSTI／LRC on
.
Notification sent to SFAA on
. (Appl. No:
).
Notification sent to Parent／Guardian if the student is aged below 18 on
.
Reply sent to Student on
.
Signature of Responsible Staff :
Date :
(Name／Post)
III.
CONFIRMATION ON WITHDRAWAL OF STUDY
This is to confirm that Mr／Ms
is de-registered from the course with effect from
Signature of SCO :
*
Delete as appropriate
TYAR 17
(Revised 1/14)
(Course
.
Date :
Please ‘’ as appropriate.
)
Notes to Students
1. Complete the notification form and submit it to the Visitor Centre (Room C120) with
your student Card.
2. The Campus Secretariat will update the IVE Computer System upon receipt of
notification for withdrawal of study. Your Student Card should be returned together
with your notification. If you fail to do so, you should bear the consequence of any
illegal use of the Student Card.
3. Reason Code for withdrawal of study:
Code
Reason
Code
Reason
01
Personal reason
02
Joined a non-IVE FT course
04
Take up employment
05
Found the course too difficult
06
Lose interest in the course
07
Emigration
08
Joined a non-IVE part-time
Course
09
Lost of employer sponsorship
(PTD courses only)
11
Insufficient time for study
14
Financial reason
21
Accept local subvented Bachelor
degree
23
Death
15
Job Commitment
22
Suffered from sickness / injury
99
Others
4. The Campus is not responsible for the document lost in mail.
5. The Campus will dispose the document if being uncollected for three months from the
date of application.
6. Students should note that their study transcripts, award certificates and related
certification will be withheld if they have any outstanding fee (including but not limited
to tuition fees, other charges, library fines, cost of repair／replacement of damaged／
lost equipment／books) owed to the Institute or VTC.
Moreover, those who have withdrawn or being de-registered from their study with an
outstanding fee will be flagged in the student record system as debtors. These
students will be required to clear the outstanding fees owed to VTC before they are
re-admitted to another VTC programme in future.

Download Report