Out-town Arrangement

* Mandatory fields

We strive to establish a caring culture and interactive relationship with our residents. In order to better protect the residents' safety and provide assistance where necessary, we would like you to fill out this form if you plan to leave Hong Kong or have left Hong Kong for the past 14 days.

Personal Particulars

Name of Resident

Student ID

Room No.

Contact No.

Email Address

Part I : Details of Out-town Arrangement

I will be out of town shortly.

I have been out of town in the past 14 days.

Duration of the Out-town (From / To)

Destination
(Please state the city and/or country. If you have been or will go to Mainland China, please state the province/city)

Purpose of the Trip

Part II : Personal Health Condition

I have contracted diseases during my out-town trip.

I have NOT contracted any diseases during my out-town trip.

Privacy Policy on Personal Data

1. The personal data collected in this form will be used by NTTIH to administer resident’s accommodation related matters, which will become part of student’s record to the student residence. The data may be shared with other authorized departments/offices of the University, where applicable, for purposes relating to student counseling, caring services, accounting and/or statistical usage.
2. Under the Personal Data (Privacy) Ordinance, a resident may request access to, and/or correction of his / her personal data in relation to this survey. If a resident wishes to exercise these rights, he/she can write to NTTIH, 32 Renfrew Road, Kowloon Tong, Kowloon, or send an email to [email protected]. Please visit the Privacy Policy posted on the University website for details.