PDF《HKIA Frequent Visitor Channel》

试行计划 Pilot Scheme 香港国际机场访港常客证申请表Hong Kong International Airport Frequent Visitor Card Application Form 我明白香港国际机场访港常客证(访港常客证)是香港机场管理局(机管局)的财物,并按照香港国际机场访港常客证计划的条款及条件( 条款及条件)签发.

机管局有权拒绝签发,或随时撤销或取消访港常客证,而毋须给予任何通知或解释.我同意机管局可就我的申请作任何 所需的查询,并将向我收集的个人资料用作条款及条件所述用途. I understand that the Hong Kong International Airport Frequent Visitor Card (Card) is the property of the Airport Authority Hong Kong (AAHK) and is issued subject to the terms and conditions (Terms and Conditions) of the Hong Kong International Airport Frequent Visitor Card Programme. The AAHK may refuse to issue, or to withdraw or cancel this Card at any time without giving any notice or reason. I consent to the AAHK making any enquiries necessary for processing my application and using the personal data collected from me for the purposes set out in the Terms and Conditions. 声明 DECLARATION 申请人签署 Signature of pplicant 个人资料 PERSONAL PARTICULARS 最近访港详情 DETAILS OF RECENT VISITS TO HONG KONG *护照编号 Passport No. *邮寄地址 Postal Address *邮政编号 Postal Code *国家 Country *电邮地址 E-mail (请尽量填写以便日后联络 please fill in for future communication) # *名字 Other Names in Full 中文姓名(如适用)Name in Chinese (if applicable) 所属飞行常客奖励计划 Member of Frequent Flyer Programmes *国籍 Nationality 请列明你在过去12个月内,最近三次经香港国际机场访港的日期并夹附护照副本,副本上须显示持证人姓名、护照编号及最近三次的访 港记录,以资证明. Please list the dates of your

3 most recent visits to Hong Kong via Hong Kong International Airport in the past

12 months and attach a copy of your passport with the pages showing your name, passport number, and the record of

3 most recent visits for verification. 须夹附文件 SUPPORTING DOCUMENTS 1. 申请表格 Application form 2. 护照首页副本 (须包括显示持证人姓名及旅行证件编号)Passport front page copy (showing your name and document number) 3. 护照内页副本 (须载有过去12个月内最近三次访港记录)Passport pages copy (showing the record of your

3 most recent visits to Hong Kong in the past

12 months) *称呼 Salutation 先生 Mr 太太 Mrs/ 小姐 Miss/ 女士 Ms 英文姓名(如护照所示) Name in English (as shown in your passport) *签发地点 Place of Issue 台湾居民来往大陆通行证 (台胞证 )/香港特区多次有效入境许可证/网上快证编号 (如适用 ) Mainland Travel Permit for Taiwan Residents, HKSAR Multiple Entry Permit or iPermit No. (if applicable) *签发日 Date of Issue (DD MM YYYY) *到期日 Date of Expiry (DD MM YYYY) HKIAFrequentVisitorChannel 访港常客通道香港国际机场Airline Operators Committee Hong Kong International Airport 香港国际机场航空公司委员会#*姓氏 Surname 由机场管理局人员填写 FOR OFFICIAL USE ONLY 批准人 Approved by 访港常客证编号及条码 Card No. and Barcode 签发日期 Date Issued * 必须填写 Mandatory August

2011 由From (DD MM YYYY) 至To (DD MM YYYY) i ) ii ) iii ) 日期 Date 新申请 遗失 续证 会员编号 New Application Lost Renewal Member ID *请在适当的空格加上「?」 Please tick the appropriate box

0 0 # 姓氏和名字不可大於22个英文字母 First name and Other name should not be more than