戴麟趾爵士康乐基金建设工程计划赛马会青少年永久康乐设施拨款.docVIP

Please read the “Guidelines for Application” and the “Important Notes on Capital Works Project” before completing this form 填表前請參閱“申請指南”及“建設工程計劃申請須知” You may complete this application in Chinese or English. Please attach separate sheets if needed. 你可用中文或英文填寫。如有需要，可另紙書寫。 Name and address of the Organisation (in both English and Chinese) 機構名稱及地址 (請以中、英文填寫) Organisation 機構名稱 Address 地址 Contact person (in both English and Chinese) 聯絡人 (請以中、英文填寫) Name姓名 (Mr/Ms*) ( ) b) Post 職位 ( ) c) Tel No. 電話號碼 Fax No. 傳真號碼 E-mail address 電郵地址 The Organisation is registered under (Please provide documentary proof) 機構根據下列條例註冊(請提供證明文件) □ the Societies Ordinance社團條例 (Year _______________ 年) □ the Companies Ordinance公司條例 (Year ______________ 年) □ other其他 _____________________ (Year ______________ 年) Brief description of the Centre for the proposed project 擬推行計劃的中心簡介 Name and Address (in both English and Chinese) 名稱及地址 (請以中、英文填寫) Centre 中心名稱 Address 地址 b) Services and facilities offered 提供的服務及設施 Services服務 ________________________________________________________________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ Facilities設施 ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ Opening Hours開放時間 ______________________________ c) Regular membership 基本會員人數 Annual membership fee 每年會費 Utilisation Rate中心使用率 2014-2015 ________ 2015-2016 ________ 2016-2017 ________ f ) i) Does the Centre receive government subvention？ Yes/No* 中心有沒有接受政府補助？ 有/沒有* ii) If yes, please indicate the name of th