APPLICATION FORM FOR PART-TIME INSTRUCTOR

Please fill in BLOCK LETTERS

Notes: The information provided will be used for the purpose of recruitment of part-time instructor with the School. It may be accessible to persons who will process or review application matters in the School, or offices and committees at the University. Information on unsuccessful candidates will be destroyed after the recruitment exercise.

I. Personal Particulars
Name in English (Surname First)

Name in Chinese Nationality Staff ID No. (Applicable to CUHK staff only) () HKID Card / Passport No. / Do you have a valid working visa in Hong Kong? ? Address (in English) () Date of Birth

Title *

Mr. / Miss / Ms. / Mrs. /

D D

M M

YY

(
Yes

Date of Issue and Country of Issue No

Not Applicable

Telephone (Home) () Fax. No.

(Office) () Pager No. ()

(Mobile) () Email Address

Correspondence Address (if different from above)

II. Academic Attainment

Name of College or University Major Minor Date From To Cert / Dip / Degree / / Date Awarded

III. Working Experience

EXPERIENCE OTHER THAN TEACHING
Organization / Employer /

)
Date

Position Held

From

To

* Please delete as appropriate

Please Turn Over.

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TEACHING EXPERIENCE
Name of College or University Rank or Title

Date

Subject & Level Taught

From

To

Professional Memberships

IV. Specific Courses/Programmes Intended to Teach (if any) ()

Day(s) Available * Time Available

: Monday / Tuesday / Wednesday / Thursday / Friday / Saturday / Sunday : Day-time (From Evening (From a.m. / p. m.) p. m.)

Location(s) Preferred

: Hong Kong / Kowloon / New Territories

V. Expertise (Please tick as appropriate) ( 3 )

I.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17

Art, Music and The Humanities

A Chinese Art Calligraphy Western Art: Painting/Drawing 3D Art: Sculpture/ceramics/glass Computer graphics / Multimedia Design 2D Design: graphic/illustration/comic/printing/advertising Applied Design: interior/fashion/jewelry/product Photography/Cinema/Digital video Dance/drama and theatre Home Care & Craft Fungshui Chinese Music Chinese Opera Western Music Voices & choral conducting Musical instruments 3D Modeling / Animation Piano Guitar Popular music Computer music Music theories and teaching Literature History Religious Studies Philosophy Chinese poetry & classic / Chinese studies Aesthetics/Art Appreciation/Architecture Cultural Studies General Education Creative/Critical Thinking Politics Travel & Leisure Others: _____________________________________ B

II. Business & Management

A 1 2 3 4 5 6
Please delete as appropriate

B Management Marketing Public Administration Hospitality, Tourism & Service Management Recreation & Leisure Others: _____________________________________

Accounting & Finance Banking & Insurance Economics China Business Law

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III. Languages & Translation

A Chinese 1 2 3 1. 2. 3 Putonghua Cantonese Chinese Writing English Japanese Others: _____________________________________ Korean French Translation Interpretation B Translation

IV.

Computer Science & Information Technology

A Office Application B Computer Security Desktop Security Server and Network Security CCSP / CISSP / GIAC / ISACA Cryptography Bioinformatics Others: _____________________________________ Programming General Programming (Basic, Pascal, C) Object-Oriented Programming (C++, Java) Database Management & Programming (MS SQL, MySQL, Access, FoxPro, Oracle, Sybase) Windows Programming (Visual Basic, Visual C++) Web Programming (Javascript, CGI/Perl, ASP, PHP) Web Services & Component-based development (.NET Framework, Java Servlets) Computer Graphics Programming (DirectX, OpenGL) Interactive Programming (Actionscript, Lingo) MCDBA / MCSD / MCSA

1 2 3 4 5 6 7 1 2 3 4 5 6 7 8 9 10

Word Processing Spreadsheet Presentation Database PIM Acrobat Others: _____________________________________ Operating Systems / Networking / Hardware Desktop OS (DOS/Windows9x/2000/XP/MacOS) Windows Server (MCSE) Linux / Unix CCNA / CCNP Internetworking and Data Communication Computer Architecture DIY Computer Assembly PC and Hardware Configuration Others: _____________________________________ Game Design & Development

Others: _____________________________________
Mobile Application & Services Mobile & Wireless Communication J2ME programming System Programming (Symbian, Palm, Pocket PC) Others: _____________________________________ Game Programming Game Construction Theory Game Graphics Design Online Game Development 3D Game construction Mobile Game Development Others: _____________________________________ Enterprise IT solutions IT Education E-Learning Course Management System (WebCT, Blackboard) Courseware Production (e.g. Authorware, Captivate, ROboHelp, Hot Potatoes) Primary / Secondary IT Education Senior Citizens Computer courses Women Computer courses Children Computer courses Others: _____________________________________ Others Scientific Computing / Computation Mathematics Logic & Artificial Intelligent Statistical Application Digital Circuit Design Distributed Computing Concurrent & Parallel Computing User Interface Design & Interaction Computer Simulation Others: _____________________________________ Enterprise Resource Planner Project Management System Analysis & Software Engineering E-business and Internet Marketing Business Application (CRM, Finance, Accounting, HRM, Logistic etc.) Information Technology Management Computer Ethics, Cyber Law & Copyright Issues Others: _____________________________________ Multimedia Application & Digital Design Webpage Design (e.g. Frontpage, Dreamweaver, GoLive) Photo retouching (e.g. Photoshop, Firework) Publishing (e.g. PageMaker, InDesign, QuarkXpress) 2D Design (e.g. Illustrator, CorelDraw, Freehand) Animation (e.g. Director, Flash, 3DMax, Maya) Video (e.g. Premiere, After Effects, Final Cut Pro) Audio (e.g. Audition, Logic, Cakewalk) CAD/CAM (e.g. AutoCAD, Solidworks) Others: _____________________________________

1 2 3 4 5 6 7 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 9

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V.
1 2 3 4 5

Traditional Chinese Medicine & Health Care

A Traditional Chinese Medicine Tui-na Chinese Kung Fu Complementary Therapy Gerontology Education Nursing & Education Rehabilitation Science Nutrition Education Pharmaceutics Education Others: _____________________________________ B

VI.
1 2 3 4 5 6 7 8 9 10

Social Sciences, Disciplinary Forces & Security Studies

A Disciplinary Forces & Security Studies Social Sciences Anthropology Early Childhood Education Education for the Elderly Adult Education School Education Employment Schema Government & Administration Library & Information Management Psychology & Counseling Adventure Tourism Culture Tourism Social Work Sociology Womens Development Mass Communication Philosophy Other: _____________________________________ B

VI. Are you currently a full-time post-graduate student of CUHK?

Yes Student ID : Study Year : Programme : Department :

Expected Year of Graduation : _____________ Receiving studentship ?

Yes

No

(Note: Post-graduate students receiving studentship and the like from the University may, with the approval of Faculty Dean, take up part-time teaching engagements up to the number of working hours per academic year at the pay-rate as set out by the University.) ()

No I am not a full-time post-graduate student of CUHK currently. I understand that its my responsibility to inform the School of Continuing & Professional Studies immediately should I become a full-time post-graduate student of CUHK and my pay-rate may be adjusted accordingly.

Signature :

Date :

VI. Declaration
I declare that the information given by me is correct and complete to the best of my knowledge. I understand that if I knowingly supply false information or withhold any material information, The Chinese University of Hong Kong shall have the right to rescind any verbal/written offer of appointment and I shall render myself liable to dismissal if I am eventually appointed by the University.

Signature

Date

Completed application form together with photocopies of HKID Card, academic results and professional membership certificates should be sent to: School of Continuing & Professional Studies, The Chinese University of Hong Kong, Shatin, N.T. Hong Kong. (Attn.: Administration Section Personnel) ()

FOR OFFICE USE ONLY

Name of Bank and Branch Address Account Number

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