Application for Pre-approval Overseas Training

Name: (English) _______________________________  (Chinese)  ________________________
		     (SURNAME IN BLOCK LETTERS)

Trainee No: ______________________    Position Code No:______________________________

Work Address:  __________________________________________________________________

		   __________________________________________________________________

Tel : ____________  Pager : ______________  Fax : ______________  Email: ________________
________________________________________________________________________________
			       
Details of Overseas Training

Training Duration: ________________________________________________________________

Training Center: __________________________________________________________________

Overseas Training Supervisor:_______________________________________________________

Details of the Training Program: 
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Trainee’s signature:_________________________         	Date:___________________________

Educational Supervisor:______________________		Date:___________________________

Please attach relevant documents for TEC’s consideration of your application.

Completed form should be sent to Dr Siu Ming MAK, Secretary, Training and Examinations Committee, c/o Department of Clinical Pathology, Tuen Mun Hospital, 23 Tsing Chung Koon Road, Tuen Mun,  NT, Hong Kong. 
Tel: (852) 3767 1722;  Fax: (852) 2468 5351;  Email: maksm1@ha.org.hk