校友适用.doc

校友適用 Alumni Members Only 入場證編號 Card No.:__________ 大學游泳池入場證申請書 UNIVERSITY SWIMMING POOL APPLICATION FORM FOR ADMISSION CARD 致： 學生事務處學生設施組 本人，___________________，願意遵守大學游泳池之規則並適當使用泳池。茲附上劃線支票港幣二百二十元正壹張（銀行名稱______________________________________________，支票號碼：_________），繳納_________年度年費，請將游泳池入場證發給本人為盼。 To: Student Amenities Section, Office of Student Affairs I, ___________________, agree to observe the regulations of the University Swimming Pool. I hereby attach a crossed cheque of HK$220 (Name of the Bank: _______________________, Cheque number: _______________) for the annual subscription of the year . Please proceed with the admission card issuance. 申請人資料 Applicants Information 姓名（中文）Name in Chinese: ______________________________________ 姓名（英文）Name in English: ______________________________________ 畢業年份 Year of Graduation: _______________________________________ 所屬書院 College: _________________________ 系別 Faculty / Department: ______________ 住址 Home Address: ______________________________________________________________ _________________________________________ 住宅電話 Home Tel. No. : _____________ 辦事處地址 Office Address: ______________________________________________________ ________________________________________ 辦事處電話 Office Tel. No. : _____________ 如遇緊急情況，請代通知 In case of emergency, please inform: *先生／女士 *Mr./Miss/Mrs.: 聯絡電話Contact Tel. No.: 申請人簽署 申請日期 Applicant’s Signature ____________________ Date of Application_____________________ *請刪去不適用者Please delete as appropriate 備註: 請連同台端之半身近照兩張、身份證副本、畢業證書副本，以及劃線支票（抬頭為「香港中文大學」），於辦公時間內前往位於香港中文大學范克廉樓一樓之學生事務處學生服務中心辦理申請手續（如遇繁忙時間，辦理入場證人士請耐心等候）。如選擇以郵遞辦證，請逕寄香港中文大學富爾敦樓2樓212/214室學生事務處學生設施組，信封面請註明「大學游泳池入場證申請──校友證」。查詢請電3943 7216。 Note: Please submit this form together with two recent photos, copy of your HKID and graduation certificate, and a crossed cheque (payable to “The Chinese University of Hong Kong”) to the Student Services Centre of Offic