Innovation and Technology Scholarship 2023 Application Form

Please prepare the following documents (digital copy) before you fill-in the form:
1. A recent photo
2. Transcript
3. English test result
4. Certificates of public examinations
5. Other supporting documents (if any)
*You are recommended to read through the form before filling in. You may take more than 15 minutes to complete this form. There is no save and resume function for the form. Please make sure you submit your application before you leave your computer/ electronic device. Do not use a public computer/ electronic device to fill-in this form.
*The internal deadline for students of City University of Hong Kong to apply for the InnoTech Scholarship 2022 is 3 Jan 2023, 5pm. Please submit your application before the deadline.

Please contact Student Development Services (sdsfinance@cityu.edu.hk) for details.
Read and follow the Application Procedures and Eligibility & Criteria carefully prior to submitting your application. (details) Please note that shortlisted candidates must attend a Selection Interview in March or April (TBC).
Read and understand the Application Procedures and Eligibility & Criteria .*

Yes, I have
Are you student from the City University of Hong Kong?*

Yes, I am
If no, please click here to select the correct form of your university for application.
I. Personal Data:
Name in English:*

SurnameGiven Name
Name in Chinese:

姓名
Gender:*

MaleFemale
E-mail Address (permanent) :*
Where the confirmation will be send to
Phone Number:*
Mobile No.
Home Tel No.
Mailing Address :*

Street Address

Street Address Line 2

LocationState / Province

Postal / Zip Code
Please upload a recent colour photograph showing full frontal face:*
At least 600 px(W) x 800 px(H) - .jpg / .png
II. Programme Information:
Faculty / Department:*
Programme of Study:*
Major:
Student Number:*
Year of Study:*

current yeartotal years of study
III. Academic Record:
Transcript

Cumulative GPA / CGA or class ranking Max point / class size
English Test Undertaken:

HKDSE English LanguageTOEFL (Internet-based test)IELTS (Academic Module)Cambridge IGCSE English as a Second Language 0511Cambridge IGCSE First Language English 0522Pearson Edexcel IGCSE English Language (Specification A or B)Pearson Edexcel IGCSE English as a Second LanguageIB English A Language and Literature Standard LevelIB English A Language and Literature High LevelIB English B Standard LevelIB English B High Level
English Test Score:
(Overall)
(Listening and Integrated Skills)
(Reading)
(Writing)
(Speaking)
(Transcripts for both GPA/CGA and English Test should be submitted together as supporting documents)

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Qualifications and Open Examinations Result
Qualifications / Open Examinations (1):*
Secondary School / Institution (1):*
Results (1)*
Qualifications / Open Examinations (2):
Secondary School / Institution (2):
Results (2)
Qualifications / Open Examinations (3):
Secondary School / Institution (3)
Results (3)
(Certificates of public examinations should be submitted together as supporting documents)

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Academic Awards or Scholarships Received (secondary school, college and university)–
(Supporting documents / proofs if any)

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IV. Extra-Curricular Activities and Community Services (secondary school, college and university)
Provide maximum 6 Extra-Curricular Activities and Community Services for reference:*
(Supporting documents / proofs if any)

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V. Preliminary Indication of University/Institution for Attachment Programme :
Number of Attachment Programme to be proposed:*
Please estimate the cost of the Attachment Programmes based on the following items that may covered by the Scholarship:
1. Tuition and application fee
2. Accommodation and board
3. Books and other supplies
4. Airfare and visa application
5. Other mandatory cost

*Under the pandemic, the arrangement for Overseas/ Mainland Attachment Programme of the Scholarship may change. Please refer to this page for latest update, or contact Scholarships & Financial Aid Office for details.
Summary of the Attachment Programmes:*
*Please note that the Scholarship period is 1/6/2023 - 31/7/2024. Your attachment programmes should fall into the Scholarship period.
Total estimated cost:*
(Supporting documents / proofs if any)

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Brief description of the plan of the Attachment Programmes (maximum 300 words):*

0/300
VI. Local Internship Programme (Optional):
Do you wish to join the optional internship programme if you are successfully awarded with the Scholarship? (please jump to section VII if your answer is No)*

YesNo
Preference of nature / field of the internship:
Preferred duration for internship:
weeks (maximum 12)
Preferred period for internship:
(DD/MM/YYYY - DD/MM/YYYY) *The period should not be overlapped with attachment programmes
VII. Mentorship Programme:
Do you have preference for your mentor if you are successfully awarded with the Scholarship? (please jump to section VIII if your answer is No)*

YesNo
Preference of the academic field of your mentor:
Preference of learning aspects from the mentor:
(e.g. entrepreneurships, research, leadership skills)
(e.g. entrepreneurships, research, leadership skills)
VIII. Statement of Interest
Please share:

(1) your plan of using the scholarship and your innovative project;

(2) your long-term career aspirations in the field of innovation and technology; and

(3) how would you contribute for the betterment of our society using your innovation and strength in science and technology.

(4) your views on the topic and possible actions related to environmental protection or long-term sustainable development in your field of study.

(maximum 150 words for each part)
(1) Scholarship plan:

0/150
(2) Long-term career aspirations:

0/150
(3) Potential contributions to the society:

0/150
(4) Environmental protection or long-term sustainable development in your field of study:

0/150
IX. Declaration
1. I certify that all the information provided in this application is true and accurate to the best of my knowledge. In the event that any information is found untrue or inaccurate in the future, the Scholarship Secretariat reserves the right to invalidate any application, withdraw the scholarship approved and require any payment made to be refunded.

2. I agree that information provided in this application will be used and/or disclosed by the Scholarship Secretariat to relevant parties to process the application as well as for related purposes, such as conducting selection interviews, monitoring of progress, etc.

3. I understand that if I am awarded the Innovation and Technology Scholarship, I will automatically become a member of "Hub for the Future" programme, which is a talent hub for HSBC Scholars jointly organised by HSBC and HKFYG. The information provided in this application will be used for communications and event promotion purposes of "Hub for the Future".

4. I've read and agree with the personal information collection statement and privacy policy of HKFYG.

By signing in the space below, you agree with the above declaration. Please print for your records and retain as verification of your application.
E-Signature:*

Clear
Should be Empty:

I. Personal Data:

II. Programme Information:

III. Academic Record:

IV. Extra-Curricular Activities and Community Services (secondary school, college and university)

V. Preliminary Indication of University/Institution for Attachment Programme :

VI. Local Internship Programme (Optional):

VII. Mentorship Programme:

VIII. Statement of Interest

IX. Declaration