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Name(Last/Family, First/Given, Middle):
Occupation:
Monthly Income (HK Dollars):
Name of Employer, address and contact number (separated by line):
Residence (Present) Address:
Email Address:
Home Phone in HK:
Mobile Phone:
Gender:
Marital Status:
Date of Birth (Ex: January 1, 1980):
Religion:
Father's Name:
Occupation:
Mother's Maiden Name:
Occupation:
Educational Background (School, From year to year, Degree) (Elementary to Tertiary, separated by a line):
Desired Program:
(Click)
Licensure Examination for Teachers Review (LET in Bangkok)
Bachelor of Arts in English (AB English)
Bachelor in Elementary Education (BEEd)
Bachelor of Science in Special Education (SpEd)
"Ladderized" Bachelor of Arts in Business Administration (BSBA+GradDipT)
"Ladderized" Bachelor of Science in Nursing (BSN)
Graduate Diploma in Teaching
"Ladderized" Master of Arts in Teaching (major in English for non-Educ graduates)
Master of Arts in Teaching (major in English for Educ graduate)
Master of Arts in Teaching (major in Special Education)
Master in Management (Educ. Mgmt.) (MMEM) / MBA
Master in Management (major in Health Administration)
PhD in Institutional Development Management (PhD-IDM)
Other (please specify below)
Other Desired Program (Optional, please specify):
Which local organization are you affiliated?
"I hereby certify that all the written information about myself herein is correct. I further agree that I have understood my rights and responsibilities expected of me as a student at SRIA/SRTMC. I promise to be committed to finishing my program in good faith."
(click)
Yes, I do.
No, I don't.
Date of Application (Month/Day/Year):
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