申请表格-社会福利署.doc

公开筹款许可证申请 Public Subscription Permit Application Form （根据香港法例第228章《简易程序治罪条例》第4(17)(i)条签发的许可证 (A Permit issued under Section 4(17)(i), Summary Offences Ordinance, Cap. 228) 在填写本表格前，先阅读载于附录的公开筹款许可证。 Please read the Explanatory Notes at Appendix before completing this application form. 填妥的申请必须在举活动最少送达 香港湾仔皇后大道东2号 36楼301至02室 社会福利署 ［经办人：二级行政主任（慈善筹款监管）。 （注：afc@.hk） The completed application form should reach the following address at least four weeks (but not more than two months) before the commencement of the proposed activity: Lotteries Fund Projects Section Social Welfare Department Rooms 3601-02 36/F, Sunlight Tower 248 Queen’s Road East, Wan Chai, Hong Kong [Attention: Executive Officer II (Fund-raising Control)] (Note: If the application form is submitted by email, it should be sent to afc@.hk with digital signature supported by e-Certificate.) 请于适当项目(加?(。 请删去不适用者。 Please tick the appropriate item. Please delete as appropriate. 申请机构的资料 Particulars of Applicant Organisation 请提交贵机构的注册证书，例如由公司注册处所签发的公司注册证书副本一?份。 (Please enclose a copy of the valid certificate of registration and proof of registered address of your organisation, e.g. Certificate of Incorporation issued by the Companies Registry.) 1. 机构中文名称 Registered Name of Organisation in Chinese 机构英文名称 Registered Name of Organisation in English 2. 机构公开筹款机构 Contact Details of Organisation (The Public Subscription Permit will show the registered address in Chinese and English, telephone number and website of the organisation) 中文地址 Registered Address 英文地址 Registered Address 通讯地址（如与注册地址不同） Correspondence Address (If different from registered address) 网址（如有） 电邮 Website (if available) E-mail 电话 传真 Tel. No. Fax No. 3. 机构主席或机构负责人姓名 Name of Chairperson / Head of Organisation （中文 （先生／太太／小姐／女士）* (English) (Mr/Mrs/Miss/Ms)* 香港身份证／护照号码 Hong Kong Identity Card / Passport No. 职位 Post Title 联络电话 Contact Telephone No. 4. 负责管理上述机构人士的资料 Details of office bearers responsible for the administration of the organisation 职位 姓名 P