hkmh_afgvgts.docVIP

香港九龍尖沙咀漆咸道南100號 100 Chatham Road South, Tsim Sha Tsui, Kowloon, Hong Kong 團體免費參觀及導賞服務申請表 Application for Free Group Visit Guided Tour Service 電話預約 / 查詢Telephone Booking / Enquiries：? 2724 9080 傳真 Fax：? 2724 9090 星期一至五 Monday – Friday : 9:30 am – 12:30 pm 2:30 – 5:30 pm 填寫前請先閱讀第三至四頁的申請須知 Please read the Notes on Application on p.3-4 before filling in this form. 博物館於星期一、四、五、六及日提供團體參觀服務。星期二休館；星期三免費入場 (專題展覽或需另外收費)。 Group visit service is available on Monday, Thursday, Friday, Saturday and Sunday. The Museum closes on Tuesday. Free Admission on Wednesday (except for some Special Exhibitions). 甲 部： 豁 免 入 場 費 申 請 Part A： Application for Free Admission 學校/團體名稱（須與證明文件相同） Name of School / Organization (as shown on the supporting document) ? 註冊學校： 幼稚園 / 小學 / 中學 / 其他（請註明） Registered school: kindergarten / primary / secondary / others (please specify) ? ＊註冊慈善團體 Registered charitable organization ? ＊註冊非牟利機構 Registered non-profit-making organization ? 其他（請註明）Others (please specify) (＊ 請附上有關證明文件副本 Please furnish certified copy of the supporting document) 團體地址 Address 負責老師/活動負責人 Officer-in-charge 聯絡電話 Telephone No. 傳真號碼 Fax No. 擬參觀日期Date of Visit 參觀時間 Time of Visit 由From: 至To: 學生/成員人數 No. of Students/Members (1) 年級（學校適用）/ 年歲Class (For School) / Age 隨行老師/領隊數目 No. of Teachers/Leaders (2) 是否需要為殘疾人士作特別安排？ Any special request for visitors with disabilities? ? 需要 Yes ___________________ ? 不需要 No 參觀總人數 Total No. of Visitors (1)+(2) 學校/團體有否為參觀本館而額外收取入場費？ Do you charge members for admission to the Museum? ? 沒有 No ? Yes 有（$ ） 此部分須由學校/團體負責人，如校長、主席、行政秘書等簽署 This part should be completed by the Authorized Officer of the school / organization, e.g. the Principal, the Chairman or the General Secretary. 茲證明上述資料均正確無訛，並無遺漏。 The undersigned hereby certifies that all the information given on this form is correct and complete. 校長/團體負責人姓名 (正楷) Name of the Principal / Authorized Officer (in Block Letters) 簽署 Signature 日期 Date 學校/團體