填表时务请参阅二零1零至11年度禁毒基金拨款计划指.docVIP

PAGE 二零一零至二零一一年度 二零一零至二零一一年度 禁毒基金撥款計劃 Beat Drugs Fund 2010/11 Funding Exercise 填表時務請參閱?二零一零至一一年度禁毒基金撥款計劃指引?，申請表須於二零一零年三月三十一日下午六時或之前送交禁毒基金會(香港金鐘道66號金鐘道政府合署高座30樓保安局禁毒處轉交) This form should be completed with reference to “Guide to Beat Drugs Fund 2010/11 Funding Exercise”. It should be returned to the Beat Drugs Fund Association, c/o Narcotics Division, Security Bureau, 30/F, High Block, Queensway Government Offices, 66 Queensway, Hong Kong on or before 6:00 p.m. on 31 March 2010. PAGE 5 此欄無須填寫 For Official Use Only 檔案編號 Reference No: 禁毒基金申請表 Beat Drugs Fund Application Form (可用中文或英文填寫。To be completed in Chinese or English) 甲部 計劃資料 Part A Project Information 計劃名稱 Project name 中文 Chinese: __________________________________________________________ 英文 English: __________________________________________________________ 申請人/機構 Applicant 中文 Chinese: __________________________________________________________ 英文 English: __________________________________________________________ 地址: Address: ________________________________________________________ _________________________________________________________________ _________________________________________________________________ 電話: 傳真: 電郵地址: Tel. no. _____________ Fax no. ___________ E-mail address ___________  負責人: 職銜: Responsible person: ____________________ Post title: ________________ 可提供更詳盡資料的人士 (如與上述填報的負責人不同) Person to be contacted for further information (if different from the responsible person) 姓名 : 職銜 : Name _______________________ Post title _________________________ 地址 : Address _________________________________________________________ ________________________________________________________________ 電郵地址 : ____________________________________ E-mail address ______________ 電話: 傳真: Tel. no. __________________________ Fax no. ________________________ III. 申請人/機構背景 Background information of applicant (a) (i) 如屬機構，請註明 For applicant organisation, please state -