PDF《THE JAPAN SOCIETY OF HONG KONG》

10/2013 THE JAPAN SOCIETY OF HONG KONG MEMBERSHIPAPPLICATION FORM Please complete using BLOCK LETTERS> In order to expedite your application, please complete in full.

All personal information provided by the applicant will be used by JSHK for communications purpose only. Please select one of the following: INDIVIDUAL MEMBER COUPLE MEMBER CORPORATE MEMBER Please complete in English for data input: Name: Mr/Mrs/Miss/Ms/Dr Chinese Character: Date of Birth:I.D. /Passport No.Nationality: Name of Company/Organization: Nature of Business/Occupation: Position: Office Address: Tel:Fax: Residential Address: Tel:Fax: E-mail Address:Mobile Phone: Education level: Degree or above Tertiary/Associated Degree Secondary Others (please specify) Membership in Other Organizations: 1.2. 3.4. Please complete if applying for COUPLE MEMBER: Name of spouse: Mrs/Mr Chinese Character: Date of birth:Nationality: Your special interests in: Arts in General Architecture Business/Industry/Economy Others: Literature Flower Arrangement Science & Technology Drama/Cinema Sports/Pastimes Travel Music History Japanese Language Painting/Calligraphy Education Life in Japan Language preferred (for lectures): English Japanese Chinese Signature of Application (Company Stamp, if applicable) Signature of Spouse (if applicable) Date of application Please send correspondence to: Home Address Office Address E-mail Address Reference Person (if available) Name Tel. No. Name Tel. No. Please submit your application form to: Secretary-General, The Japan Society of Hong Kong, 1/F, Fung House, 19-20 Connaught Road C, Central, Hong Kong. * Delete as appropriate For offical use: Membership fee Bank/ Cheque no.Received date Membership no.Date of Join Staff