Microsoft Word - enrollment form for online.doc

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步走大自然 @ 米埔 202 報名表格 Walk for Nature @ Mai Po 202 Enrolment Form 截止報名日期 Enrolment Deadline: 30 September, 202 參加組別 Category ( 請於適當位置上加號 please tick the appropriate box) 成人 Adult : 最低籌款額 Minimum

1 米埔 202 報名表格 Walk for Mai Po 202 Enrolment Form 截止報名日期 Enrolment Deadline: 30 September, 202 參加組別 Category ( 請於適當位置上加號 please tick the appropriate box) 成人 Adult : 最低籌款額 Minimum Donation: 每人港幣 HK$500 /person 家庭 Family : 最低籌款額 Minimum Donation: 每個家庭港幣 HK$,500 /family 每個家庭包括最多 2 名成年人士及 2 名 8 歲以下人士 Each family includes two adults and two members aged 8 or below. 青少年 Youth : 8 歲以下或全日制學生 Aged 8 or below or Full-Time Student 最低籌款額 Minimum Donation: 每人港幣 HK$300/person 長者 Elderly : 60 歲以上人士 Age above 60 years old 最低籌款額 Minimum Donation: 每人港幣 HK$300/person 個人資料 Personal Particulars ( 如屬家庭組別, 請填寫聯絡人資料 For Family category, please fill in personal information of contact person) 請以英文大楷英文大楷填寫 Please fill in ENGLISH BLOCK LETTERS () 稱謂 Title: 小姐 Miss / * 姓氏 Surname: 名字 Given name: 性別 Gender: 男 Male / 女 Female * 出生日期 Date of Birth: 出生日期日 DAY 月 MONTH 年 YEAR* * 香港身份證號碼 HKID No./ 護照號碼 Passport No. : ( 必須填寫, 作為申請進入米埔自然保護區許可證之用 Compulsory field for application of Mai Po permit) 電郵傳真 * 電郵住宅電話公司電話住宅電話 Home phone: 公司電話 Office phone: 傳真 Fax. no.: 電話 Mobile phone: 傳真手提電話 ( 必須填寫至少一個聯絡電話 Provide at least one telephone number) 地址 Mailing Address : 室 Room 樓 Floor 座 Block * 地址大廈 Name of Building / 屋苑 Estate 街 / 道及號碼 No. & Name of Street / Road 地區 District 香港 HK 九龍 Kowloon 新界 New Territories 離島 Outlying Islands

2 與親友同行 Walk with Companions ( 如適用 if applicable) 如計劃與親友同行, 請先於取得組別編號, 以便本會安排同行人士於同一時段出發 Participants who would like to walk with relatives/ friends together at the same time, please get a Group Number from first, then, it can be arranged accordingly. 組別編號 Group Number : 家庭組別成員個人資料 Personal Particulars of Family Participants 只供家庭組別填寫 For Family Category Use Only ( 每個家庭包括最多 2 名成年人士及 2 名 8 歲以下人士 Each family includes two adults and two members aged 8 or below) 英文大楷填寫姓名 Please fill in the name in ENGLISH BLOCK LETTERS 請以英文大楷 * 稱謂 *Title * 姓名 *Name * 出生年份 *Year of Birth * 身份証 / 護照號碼 ( 作為申請進入米埔自然保護區許可證之用 ) 個人資料欄家庭組別聯絡人請填資料於首頁的個人資料 Please fill in Family team contact person information in the Personal Particulars in the first page *HKID / Passport No. (For application of Mai Po permit) / / 日期及時間 Date and Starting Time * 請選擇您的步行日 Please choose your preferred date and time: 日期 Date 202 年月日 November 年月 8 日 8 November 202 起步時間 Starting Time 選擇 Preference ( 為首選,2 為次選, 如此類推 as first choice, 2 as second choice etc.) 注意 : 起步時段將會由本會職員安排於上述時段之內 Note: starting time will be assigned by WWF staff within the above time range. 2

3 捐款方法 Donation Methods 請選擇以下其中一種捐款方法 Please choose one of the below donation methods: 劃線支票 Crossed Cheque 抬頭為世界自然 ( 香港 ) 基金會的劃線支票基金會 #; 或 A crossed cheque made payable to WORLD WIDE FUND FOR NATURE HONG KONG, OR 請勿郵寄現金 # 為盡量善用您的捐款, 請勿使用外幣支票, 以免銀行收取手續費請勿郵寄現金請勿郵寄現金 Please do not send cheques in foreign currencies in order to avoid handling charge to be incurred. Please DO NOT mail CASH! 信用卡 Credit Card Visa Master Card American Express Diners Club * 豁免本會手續費 service charge waived 信用卡號碼 Credit Card Number 持卡人姓名 Name of Cardholder 信用卡有效日期至 Expiry Date ( 月 M) / ( 年 Y) 簽署 Signature 繳費靈 PPS Payment 使用繳費靈電話或網上服務, 本會商戶號碼 : 9502, 請填上繳費靈交易號碼 PPS payment via phone/internet, WWF merchant no.: 9502, please fill in the PPS transaction reference number: 其他資料 Other Information 您是否世界自然基金會會員 Are you a WWF member? 是 Yes, 會員編號 * Membership No*: 您是否曾參加過曾參加過米埔是 Yes 否 No 您如何得知米埔 202 的活動資料可選多項 More than one choice : 否 No 米埔? Did you join Walk for Nature before? 的活動資料?How did you know about Walk for Nature 202? 港鐵站海報 MTR Poster 雜誌 Magazine 報紙 Newspaper 海報 Poster 本會網站 WWF Website 本會電子報 WWF E-news 生命之延雜誌 About Life Magazine 學校 Schools 朋友 Friends 公司 Company 遞交方法 Submission Methods 其他 Others ( 請註明 Please specify): ) 郵寄報名 Register by Mail ( 接受以支票信用卡或繳費靈付款 Accept credit card, cheque or PPS payment) 請填妥此報名表格, 並連同劃線支票或信用卡資料或繳費靈交易號碼郵寄 : 香港中環纜車徑一號世界自然 ( 香港 ) 基金會 Please fill in this enrolment form together with a crossed cheque/credit card payment/pps transaction reference number and mail to: World Wide Fund for Nature Hong Kong, No. Tramway Path, Central, Hong Kong 2) 傳真報名 Register by Fax ( 只接受信用卡或繳費靈付款 Only accept credit card or PPS payment) 請填妥此報名表格包括所需信用卡資料或繳費靈交易號碼傳真至如以傳真方式報名, 無須寄回表格正本請保留表格以便日後參考無須寄回表格正本 Please fill in this enrolment form with credit card information or PPS transaction reference number accordingly and fax it back to In order to avoid duplication, please DO NOT mail us the original enrolment form after faxing us a copy; please keep it for future reference. 3

4 贊助表格 Sponsorship Form 邀請您的親友贊助您的參與! 贊助人數愈多, 保護環境的力量愈大! 最高個人籌款者 # 更有機會獲得全新 ipad 連 Wi-Fi 6GB ( 第 3 代 ) 乙部, 價值港幣 3,888 元請以英文正楷填寫贊助人姓名, 捐款港幣 00 元或以上的贊助人可獲發免稅收據, 而收據將於 203 年 2 月 8 日前發出 # 需達到最低籌款額為港幣 20,000 元 Please invite friends and family to sponsor you! The more sponsors, the more funds can be raised to protect our environment! The top fundraising individual# could receive a new ipad with Wi-Fi 6GB (3 rd generation), which worths HK$3,888. Please write the sponsors details in BLOCK LETTERS. Tax-deductible receipt will be issued by 8 February 203 for donation of HK$00 or above. #with minimum donation of HK$20,000. * 參加者加者姓名 Name of Participant: * 組別編號 ( 如有 * 聯絡電話號碼 Contact Phone No.: * 電郵 * 稱謂 *Title * 贊助人姓名 *Name of Sponsor 如有 ) Group No. (if any): 電郵電郵地址電話號碼 Address Phone no. * 金額 *Amount ( 港幣 HK$) 例 e.g. CHAN TAI MAN, CHRIS $500 ctmchan@xxx.com 如本表格不敷應用, 請自行複印總額 Total 自行複印 If the fields are not enough, please make copies. 4

5 注意事項 Notes. 名額有限, 先到先得, 額滿即止如名額已滿, 而閣下未能成功報名, 請把已籌得的善款捐贈本會 Registration will be on a first-come-first-serve basis. Unsuccessful applicants are encouraged to donate the collected funds to WWF. 2. 為免向隅, 請考慮盡早報名及自行預繳最低籌款額, 隨後再向親友籌募善款贊助 To register early and reserve a place in the event, you may consider prepaying the minimum donation amount and ask for your friends sponsorship afterwards. 3. 如計劃與親友同行, 請先取得組別編號, 並把該組編號填寫於各同行人士的報名表, 以便本會安排同行人士於同一時段出發 If you would like to walk with relatives/ friends together at the same time, please get a Group Number first, and mark down that Group Number in each participant s enrolment form. 4. 本會於收妥報名表格及捐款後, 於 0 個工作天內向參加者發出核實電郵 Upon receipt of the enrolment form and donation, a confirmation will be sent to the participant within 0 business days. 5. 活動步行證及詳情將於 202 年月 2 日或之前專函奉達 Walk permit and details will be sent to participants on or before 2 November, 如須於報名後補交贊助人資料, 請於 202 年月 30 日前送交本會, 以便一併發出收據如參加者未有填妥贊助人資料或交回贊助表格, 參加者將自動成為贊助人 Please send additional sponsors' information to WWF after enrolment before 30 November, 202 for receipt issuance. Applicants will consider as self-sponsored if no sponsorship information provided. 7. 捐款港幣 00 元或以上的贊助人可獲發免稅收據, 而收據將於 203 年 2 月 8 日前發出 Tax-deductible receipt will be issued for donations of HK$00 or above before 8 February, 閣下與捐款者的個人資料只用作發收據募捐及通訊之用, 絕對保密如不欲收到本會的刊物, 請來函通知 You and your sponsors personal particulars will be treated in strict confidence and will be used for receipting, fundraising and communication purposes only. Please notify us in writing if you do not wish to receive any mailings from WWF. 9. 如於活動當日早上 6 時懸掛任何暴雨或颱風警告訊號, 或由於其他不穩定天氣及其他非本會能力控制的外在因素影響, 世界自然基金會保留取消是次活動的權利, 而所有善款恕不退還參加者可把募捐款項當作捐款, 支持本會的保育及教育工作 WWF reserves the right to call off the Walk for Nature charity walk in the event of (i) adverse weather conditions and/or other incidents beyond the control of WWF, and (ii) rainstorm or typhoon signal hoisted at 6 o clock in the morning of the event day. All donations are non-refundable. In case the event is cancelled, participants could also donate the collected funds to WWF-Hong Kong to support our conservation and education work. 0. 如有任何查詢, 請致電 ( 選擇語言後按 4,3) 或電郵至 walk@wwf.org.hk 與本會聯絡 If you have any enquiries, please contact us at (choose language then press 4,3) or to walk@wwf.org.hk. 5

Microsoft Word - enrollment form for online download.doc

Microsoft Word - enrollment form for online download.doc 參加組別步走大自然 @ 米埔 2010 報名表格 Walk for Nature @ Mai Po 2010 Enrolment Form 截止報名日期 Enrolment Deadline: 30 th Sept, 2010 組別 Category( 請於合適位置加上號 please tick the appropriate box) 成人 Adult : 最低籌款額 Minimum Donation: