活化历史建筑伙伴计划.pdfVIP

P. 1 活化歷史建築伙伴計劃 Revitalising Historic Buildings Through Partnership Scheme 申請表格 Application Form 1. 填寫本申請表格前請先細閱申請指引 及資料冊 。 Please read the Guide to Application and Resource Kit carefully before completing this application orm. f 2. 申請機構如欲申請使用多於一幢建築 物，每幢建築物的申請表格必須分 開填寫。 If an applicant wishes to apply for the use of more than one building, it should complete one application form in respect of each building. 3. 若申請由兩個或以上機構聯合提出，此 表格應由主要申請機構填寫。 In case of joint application (i.e. application made by two or more organisations jointly), the principal or lead organisation should fill in this form. 4. 此表格可用中文或英文填寫。 This form may be completed in either Chinese or English. 5. 如表格不敷應用，請另紙書寫。 Please attach sheet(s) if more space is required. 6. 請在每頁之右下角簡簽。 Please initial at the lower right hand corner of each page. 7. 請填寫在 D13部的核對清單 。該清單須由一名機構董事簽署核實，然後連同 申請表格 一併提交 Please complete the Checklist in Part D(13) which should be signed by a director of the Organisation and submitted together with this Application Form. 申請使用之建築物 Building applied for use Lui Seng Chun 計劃名稱 Lui Seng Chun Chinese Medicine Project Title and Herb Tea Shop 申請機構 Applicant Sincere Community Services Centre 簡簽 Initial Sample Application (All contents are fictitious) P. 2 I. 申請機構資料 Particulars of Applicant(s) 如申請由兩個或以上機構聯合提出，主要申請機構請取得協辦機構之同意以填寫本表 格，並提供有關資料。 In case of joint applicatio