The Hong Kong Polytechnic University

Department of Civil and Environmental Engineering

Congrats! You are identified as one of the potential nominees of various student awards and scholarships offered
by the University and external bodies. To facilitate the Department’s recommendation, you are invited to provide
more information about yourself.
The personal information collected below will only be used by the Department to conduct initial assessment on
your suitability for nomination of various student awards and scholarships. If you will be nominated for a specific
award/scholarship, the Department will inform you separately.

Name : (in English) (in Chinese)

Programme : Year of Study:

Student ID: Cumulative GPA by
Semester One of 2017/18:
Contact no.:

Please list out your achievements/contribution/participation in academic, community services, leadership

qualities, extra-curricular activities and sport in the order of importance.

Date of achievement Details (e.g. name of activities, scores etc.)

Academic Achievement (e.g. if
you have attended TOEFL or
IELTS, please provide the scores in
different areas)
Participation in Community
Services

Leadership Achievement

Extra-curriculum activities

Sport Achievement

Supporting documents are not required at the moment. The Department will approach you for more details if you
are deemed suitable for nomination to compete for a particular award/scholarship. You may be invited to meet
your Programme Leader, provide supplementary information or attend interview before making the nomination,
if deemed necessary.

If you have any questions, please contact the General Office at 2766 6068.