康乐及文化事务署-康体通用户申请表

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1、康樂及文化事務署－康體通用戶申請表LEISUREANDCULTURALSERVICESDEPARTMENT–LEISURELINKPATRONAPPLICATIONFORM康文署專用FOROFFICIALUSEONLY資料已核對Informationchecked是Yeso核對記錄員Recordcheckedby(Name/Post)/日期/Date:申請編號ApplicationNo:________________檔案記錄員Recordcreatedby:_____________I.申請人資料PARTICULARSOFAPPLICANT姓名Name(英文inEnglish):(請用正楷填

2、寫inBLOCKletters)(中文inChinese):____________________________________________________________________(如適用ifapplicable)中文姓名電碼ChineseCharacterCode:出生日期DateofBirth:性別Sex*:男Male女Female日DD月MM年YYYY香港身份證號碼:HongKongIdentityCardNo.(未滿11歲而並未持有香港身份證的兒童，請填寫出生證明書/簽證身份書/回港證/前往港澳通行證(俗稱單程證)號碼(Applicantsundertheageof11

3、whodonothaveaHongKongIdentityCardshouldentertheirbirthcertificateno./DocumentofIdentity/HKSARRe-entryPermit/One-wayPermit)通訊地址:______________________________________________________________________________________________CorrespondenceAddress__________________________________________________________

4、____________________________________電話號碼Tel.No.(日間Daytime):___________________________手提電話／傳呼機號碼Mobile/PagerNo.:______________________傳真號碼FaxNo.:____________________________電郵地址E-mailAddress:_____________________________________收取申請通知書(請選擇一項方式)Receiveacknowledgementby(pleaseselectonemethod):電郵Email郵

5、寄Mail傳真FaxII.申請人的家長或監護人資料（只供未滿18歲申請人的家長或監護人填寫）PARTICULARSOFPARENTORGUARDIANOFAPPLICANT(tobecompletedbytheparentorguardianofanapplicantundertheageof18)姓名Name(英文inEnglish):(請用正楷填寫inBLOCKletters)(中文inChinese):____________________________________________________________________(如適用　ifapplicable)中文姓名電碼Ch

6、ineseCharacterCode:出生日期DateofBirth:性別Sex*:男Male女Female日DD月MM年YYYY香港身份證／旅行證件號碼:HongKongIdentityCard/TravelDocumentNo.通訊地址(如與申請者地址不同):___________________________________________________________________________________________CorrespondenceAddress(ifdifferentfromthatoftheapplicant):____________________

7、_________________________________________電話號碼Tel.No.(日間Daytime):_____________________________電郵地址E-mailAddress:___________________________________與申請人關係*Relationshipwiththeapplicant*:父Father母Mother監護人