LETTER OF AUTHORIZATION (Year 2006)

To: JUPAS Office / Institution concerned (as applicable)

I hereby authorize the following person as my representative:

Please [ 3 ] the appropriate box AND complete the details that follow

MAIN ROUND OFFER (2 –4 AUGUST 2006 at the institution concerned)

to collect the offer letter, and to confirm acceptance of offer on my behalf at the institution
concerned.

HKALE APPEAL (AUGUST 2006)

a) to submit a request for reconsideration of my application subsequent to my upgraded
HKALE results on 4 or 5 AUGUST 2006; and
b) to return the form for re-prioritization of my original programme choices, and to collect the
confirmation slip of my final priority of study programme choices on 4 or 5 AUGUST
2006; and
c) to sign and return the acceptance form of offer, if a better offer is given, on my behalf.

In the event that amendment(s) is/are required, my representative is authorized to make ALL
the necessary amendment(s) on my behalf.

YOUR REPRESENTATIVE MUST REACH THE AGE OF 18,

PRESENT COPY OF YOUR HKID CARD and HIS/HER OWN HKID CARD

1. Name of Representative : ___________________________________________________

(IN BLOCK LETTERS)

2. HKID Card No. : ( )

3. Relationship with Applicant* : Parent Brother/Sister Friend

Other (Please specify): __________________________________________

4. Age 18 or above*: 5. Signature of Representative: ___________________________

*Please [ 3 ] the appropriate

I understand that any decisions made by my representative as named above will be FINAL and
IRREVOCABLE.
6. Name of Applicant: ______________________________________________________________
(IN BLOCK LETTERS)
7. Application No.: 0 6
8. HKID Card No.: ( )

9. Date: ____________________________ 10. Signature of Applicant: ____________________