香港中文大学物理系-HKPHY.doc

物理園 香港物理教育網站 網址: / 傳真: 2603 5204 所有香港全職中學物理科教師均可成為物理園的會員。請填寫這表格，傳真至2603 5204或物理園工作小組收。我們會以電郵方式，回覆你的申請。 會員申請表 [為方便電腦輸入，除了中文姓名外，請以正楷英文填寫本表格] 英文姓名 中文姓名 聯絡電話 學校名稱 學校電話 學校地址 電郵地址 [必須填寫，以便回覆你的申請。] 戶名 (Username) (選擇一) 只可以數字或英文字母填寫(請注意大小楷) (選擇二) (選擇三) 密碼 (Password) 本人謹此聲明以上所提供之資料均屬真實，如申請獲得批准，本人不能將個人之戶口轉讓或借給他人使用。本人明白倘若故意虛報資料，本人之戶口將被取消。本人亦明白以上提供之個人資料祗供聯絡用途，物理園工作小組在未經本人同意下不可把這些資料提供於第三者。 校印 日期 簽署 如欲查詢，請致電湯兆昇博士（3943 6400），或電郵sstong@.hk。 Physics World A web site dedicated to physics education in Hong Kong Address: / Fax: 2603 5204 Any full time physics teacher in Hong Kong can become a member of Physics World. Please fill in the following form, and send it by fax to 2603 5204 Physics World Working Group. We will reply you by email. Membership application [Please enter the form in ENGLISH BLOCK letters for easy data entry.] Name (English) Name (Chinese) Contact Tel. Name of School School Tel. School Address E-mail Address [This part MUST be completed. We will contact you via e-mail.] Username 1st Choice Alphanumeric characters only (case sensitive) 2nd Choice 3rd Choice Password I declare that the above data are true up to my knowledge. If the application is successful, I will not transfer my account to any other person nor let any other person use my account. I understand that if I enter false information intentionally, my account will be cancelled immediately. I also understand that the above personal data are used for contact purpose only. The working group of Physics World cannot transfer the data to any third party without my consensus. School Chop Date Signature For enquiries, please contact Dr. S.S. Tong at 3943 6400, or send e-mail to sstong@.hk.