康乐及文化事务署-康体通临时用户申请表.doc

康樂及文化事務署－康體通臨時用戶申請表 (供持有有效旅行證件的旅客 及獲准短期留港人士使用) LEISURE AND CULTURAL SERVICES DEPARTMENT – LEISURE LINK TEMPORARY PATRON APPLICATION FORM (For visitors or persons granted temporary stay in Hong Kong who have a valid travel document) 康文署專用 FOR OFFICE USE ONLY 申請編號 Application No. : ____________________________ 記錄員 Record created by : _______________________ 申請人資料 PARTICULARS OF APPLICANT 姓名 Name (英文 in English): (請用正楷填寫 in BLOCK letters) (中文in Chinese): _________________________________________________________________________ (如適用 if applicable) 出生日期 Date of Birth : 性別 Sex * : ? 男Male ? 女Female 日 DD 月MM 年YYYY 有效旅行證件號碼 Valid Travel Document No. 入境日期 : Date of Entry: 英國國民海外Applications using a HKSAR passport or a BNO passport issued by the British Consulate-General Hong Kong will not be accepted.) 旅行證件類別Type of Travel Document: ________________簽發機構Issuing Authority: _______________Validity of Stay逗留期限:____________ 香港通訊地址(如有) :________________________________________________________________________________________________________ Correspondence Address in Hong Kong (If any):____________________________________________________________________________________ 電話號碼Tel. No. (日間Daytime):___________________________ 手提電話／傳呼機號碼 Mobile / Pager No. : ___________________________ 傳真號碼Fax No. : ____________________________ 電郵地址E-mail Address : ______________________________________________ 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） PARTICULARS OF PARENT OR GUARDIAN OF APPLICANT　(to be completed by the parent or guardian of an applicant under the age of 18) 姓名 Name (英文in English) : (請用正楷填寫 in BLOCK letters) (中文in Chinese) : ____________________________________________________________________(如適用if applicable) 出生日期 Date of Birth