Application Form-Re-issuance of Examination Result Slip

Thank you for applying for Reissuance of Examination Result Slip. Please read below Important Notes before filling in the application form.

Important Notes:

The result slip will be sent to the applicant within 14 working days upon receipt of the completed application form.
Personal data provided by the applicant in this application form will only be used by the Institute staff for issuing the result slip.

Agree and Confirm *

I have read and understand the Important Notes and confirm that I am ready to proceed with the application.

Current Membership No. ( If applicable )

Salutation *

Surname *

e.g. CHAN (as shown on identity document)

Given Name *

e.g. Tai Man (as shown on identity document)

Preferred Name

e.g. John, Peter, Mary

Name in Chinese

(as shown on identity document)

HKID / Passport No. *

Please enter A1234567 if HKID is A123456(7)

Mobile No. *

Primary Email *

Reissuance of Examination Result Slip

Professional Qualification Programme *

Name of Module *

Date of Examination *

Fee *

Total

$0.00

Delivering Address *

Address Line 1

Address Line 2

City

State / Province / Region

Declaration *

I agree and confirm below :

1. The information I have provided in this form is true and correct.
2. I have read and understood all important notes for this application.
3. I understand that the paid fees are non-refundable and non-transferable, and application will only be processed upon receipt of payment.
4. Any incomplete or insufficient information provided on this form may lead to delay in issuing the result slip.

I would like to pay by:

Total Fee Paid

$0.00

All fees paid are non-refundable.

Read and agreed with the Privacy Policy Statement *

I have read and agreed with the Privacy Policy Statement.

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Please enter your FULL NAME to confirm the application *