Hong Kong Christian Institute APPLICATION FOR ASSOCIATE MEMBER Name:(Ms./Mr./Rev.) Chinese Name(if applicable): Occupation: Church Affiliation: Tel. No. Facsimile: Correspondence Address: Education Level: (office) E-mail: (home) I support the objective and functions of the HKCI and apply to join the Institute as an associate member. I am enclosing my membership fee / donation in the amount of ___ Cheque No. Applicant’s Signature: ___ Office use only Membership No. ___ Notes: 1. Applicants please complete the above form and return it with your payment of membership fee / donation to the Hong Kong Christian Institute, 11 Mongkok Road, 10/F., Kowloon, Hong Kong. 2. Cheques should be crossed to “Hong Kong Christian Institute” and if the cheque is not in Hong Kong Dollars, bank exchange charges of HK$60.00 should be added. 3. Associate membership fee: local HK$100 / Overseas HK$200 (or equivalent) / 50% discount for full-time students. Your personal data is only for issuing receipts, newsletter and information of courses only. If you do not want to receive news, please notify us. For inquiry, please call 2398 1699.