Application Form - Check-Out Form (For Bachelor'S Degree Programmes) Page 2
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1
2For Office Use Only
Registry
Signature and Stamp of REG
Current Status:
□
□
D- Discontinuation of study
R- Deferment of study
□
□
N- Inactive Student
W- Withdrawal from study
□
Administration fee for inactive student
RC Information:
□
□
□
□
CKPC
CKYC
CYTC
HFPJC
□
□
□
□
□
N/A
LCWC
MCMC
SHEAC
SPC
Date: ____________ / _____________ / _____________
University Library
Signature and Stamp of LIB
□
Outstanding record(s) cleared
Date: ____________ / _____________ / _____________
Residential College
Signature and Stamp of RC
□
□
□
□
□
Move-out procedure completed
CKPC
CKYC
CYTC
HFPJC
□
□
□
□
□
Non-RC resident
LCWC
MCMC
SHEAC
SPC
Date: ____________ / _____________ / _____________
Treasury Section
Signature and Stamp of TRE
□
Outstanding record(s) cleared
Date: ____________ / _____________ / _____________
AUTHORIZATION LETTER
I
(Name)
_______________________________________________
(I.D.
No
______________________
)
hereby
authorize
(Name)
________________________________________________ (I.D. No ______________________ ) to act on my behalf to complete the check-out
procedures.
I declare that the information provided in this authorization letter is correct and I have acknowledged and understood the <Personal Data
and Collection Statement of the University of Macau/the Registry of the University of Macau>.
Signature: ______________________________________________
Date: ____________ / _____________ / _____________
Note: Please submit the authorization letter together with I.D. copies of both parties.
Receipt
Signature and Stamp of TRE
The student (Name) ________________________________________
□-□□-□□□□-□
(Student No. :
) has completed the
check-out procedures on _________ / __________ / __________.
Date: ____________ / _____________ / _____________
REG/Form/002
Updated on 28/05/2015
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