DOC《参加者资料Member Data》

参加者资料Member Data 供个别人士使用To be completed by individuals 姓名(中文)先生/小姐/女士 Name (English)Mr/Ms/Madam 职业 (如适用) Profession:if applicable) 联络电话 日间 ? 晚间 Contact Tel:Day)Night) 传真 电邮 Fax:E-mail: 通讯地址 Correspondence Address: 签署 日期 Signature:Date: (II) 供团体使用 To be completed by organisations 团体名称 Name of Organisation: 联络人姓名 *先生/小姐/女士 Name of Contact Person:Mr / Ms / Madam 联络人职位 (如适用) 联络电话 Position of Contact Person: (if applicable) Contact Tel: 传真 电邮 Fax:E-mail: 通讯地址 Correspondence Address: 签署/盖章 日期 Signature/Chop: Date: (*请将不适用者删去Please delete as appropriate) 注: 上述之个人资料只作本会内部记录及联络阁下之用,如有查询或欲更正阁下之个人资料,欢迎与本会联络.

Note: The above personal data is for our internal record and for our Society to contact you. If you wish to access to or to make correction of your personal data, please feel free to contact our Society. 地址: 香港九龙深水?乐年花园保安道二号A地下 Address: G/F, No. 2A Po On Road, Cronin Garden, Sham Shui Po, Kowloon 电话 Tel: (852)

2745 0424 传真 Fax: (852)

2786 4097 网址 Website: http://www.fuhong.org 电子邮递E-mail: [email protected] 有兴趣提供之义务工作Areas of interest for voluntary service 请於适当空格内加「(」,可「(」多於一项 Please put a tick in the box(es) as appropriate, you may tick more than one box: 参与扶康会售旗日 Participate in FHS Flag Day 参与扶康会运动日 Participate in FHS Sports Day 参与扶康会家庭营 Participate in FHS Family Camp 服务单位户内 / 户外活动 Participate in indoor / outdoor activities organised by service units 协助服务单位日常运作,请注明: Assist in routine tasks of a service unit, please specify: 家务 domestic chores 照顾 caring 文书 clerical 其他 others: 探访扶康会之 *弱智/弱能人士 及/或 精神病康复者 Visiting people with *mental / physical handicap and / or those recovering from mental illnesses of our Society 举行活动让扶康会之 *弱智/弱能人士 及/或 精神病康复者参与 Organise activities for the participation of people with *mental / physical handicaps and / or those recovering from mental illnesses of our Society 其他Others: * 请把不适用者删去 Please delete as appropriate 选择提供义务工作之服务单位/区域 Preferred Service unit / district for providing voluntary service Please put a tick in the box(es) as appropriate, you may tick more than one box: 任何区域均可 Any District 荃湾区 Tsuen Wan 葵涌区 Kwai Chung 青衣 Tsing Yi 深水?区Shamshuipo 官塘区 Kwun Tong 沙田区 Shatin 屯门区 Tuen Mun 元朗区 Yuen Long 香港东区 Hong Kong East 香港南区 Hong Kong South 指定服务单位,请注明: If you wish to provide voluntary service to a particular service unit, please indicate: 倘若阁下不想再收到有关「扶康会」的任何邮递或电子信件,请加「(」号. If you wish to cease using your data for direct mailing, please tick the box. 本会谨向阁下保证,阁下提供之所有资料谨作本会内部使用,如有查询或欲更正阁下之个人资料,欢迎与本会联络. Fu Hong Society would like to assure that all information will be treated in strictest confidence and for internal use only. For access to or correction of your personal data, please feel free to contact our Society. 供本会填写To be completed by the FHS 供服务单位填写 To be completed by service unit 服务单位 填写日期 Service Unit Date of Completion: 联络职员 职位 Contact Staff: Position: (ii) 供总办事处填写To be completed by Head Office 收悉日期 负责职员 Date Received: Staff Responsible: 会员编号 跟进服务单位 : Member No : Follow-up Service unit :