CONGREGATION FOR THE CONFERMENT OF DEGREES AND OTHER AWARDS Malaysia, Saturday 29 November 2014 Singapore, Monday 1 December 2014 Hong Kong, Thursday 4 December 2014 Personal Details First Name(s): Family Name: ID Number: Title of Award: Email Address: Contact Number: Contact Address: Please confirm where you intend to graduate (tick one box only) I intend to graduate in person in Malaysia on Saturday 29 November 2014 I intend to graduate in person in Singapore on Monday 1 December 2014 I intend to graduate in person in Hong Kong on Thursday 4 December 2014 Guest Tickets Number of guest tickets required (£30.00 each) Graduation Fee and Declaration I hereby make application to graduate and enclose the appropriate fees. I understand that my name will be published in the list of graduates and that my former place of study will be informed of my graduation and degree title (unless otherwise requested in writing). Signature: Date: Please do not pass my details to the Alumni Department at Heriot-Watt University  (tick) (This information is used to keep in touch with you via Magazines, E-Newsletters and Event Invites after graduation) Form(s) should be returned to the Student Service Centre by 17 October 2014. If your form is not received by this date, there is no guarantee that you will be able to graduate. Please see the Academic Registry website for further details http://www.hw.ac.uk/registry/graduation.htm Office use only: OFF-MY-14 / OFF-SN-14 / OFF-HK-14 Programme Number 01 6640 4240 C10 01 6640 4515 C10 Grad Fee Paid £ Tickets Paid £ Date Date Certificate Sent /Collected Date Method of Payment Information Student Service Centre, Hugh Nisbet Building, Heriot-Watt University, Edinburgh, United Kingdom, EH14 4AS CONGREGATION FOR THE CONFERMENT OF DEGREES AND OTHER AWARDS Malaysia, Saturday 29 November 2014 Singapore, Monday 1 December 2014 Hong Kong, Thursday 4 December 2014    The graduation fee is mandatory A charge of 1.75% will be added to the payment for use of a credit card, to cover the cost of processing to the University Cheques/Bank Drafts should be made payable to Heriot-Watt University in Pounds Sterling and Crossed. International Graduation Fee £100.00 Number of Guest Tickets (£30.00 each) £_____ Total Cost for International Graduation £_____ Credit/Debit card payments – please fill in the details below clearly ……………………………………………………………………………………………………………………… This portion of your form will be destroyed after payment has been taken Please note; we cannot process your payment unless all details are completed Please tick or complete the appropriate boxes below Credit Card Type MasterCard  Debit Card Type Visa    Card Details Valid From Date: Expiry Date: Security Code: (Last 3 digits on signature strip) Long Card Number: Name of Cardholder: Signature :  Switch/Maestro Switch Issue No. Visa Debit/Delta *We are unable to take payment remotely from a Visa Electron Card Date: Student Service Centre, Hugh Nisbet Building, Heriot-Watt University, Edinburgh, United Kingdom, EH14 4AS