Chinese YMCA of Hong Kong
University YMCA® (Hong Kong Baptist University)
Membership Application Form
PAID STAMP
(Please complete in BLOCK LETTERS and tick the appropriate box)
□ New Member
□ Renewing Member, Membership No.﹕
Year of Membership﹕□ 1-year
□ 3-year □ 4-year (Free for 1 extra year, 5 years in total)
Name (Same as your ID Card)﹕
Student ID No.﹕
(Surname)
HKID Card No.﹕
Date of Birth﹕(yy/mm/dd)
Phone
No.﹕
______
_________
Email﹕
□
□
(First Name)
Age﹕
( )
Gender﹕
(Mobile)
Year﹕
Catalogue Year：
Faculty﹕
(Home)
Major：
@life.hkbu.edu.hk
HKBU email account My personal email account -
Address﹕
Religion﹕
Church﹕
Emergency
Contact Info. Name﹕
______________________
Date of Baptism﹕(yy/mm/dd)
Relationship﹕
Phone No﹕
□ I do wish to receive the latest news and members benefits of both Uni-Y(HKBU) & Chinese YMCA of Hong Kong via
□
mail/ email/ SMS.
I do not wish to receive the latest news and members benefits of both Uni-Y(HKBU) & Chinese YMCA of Hong Kong via
mail/ email/ SMS.
Reminders for members:
1.
2.
3.
4.
5.
6.
7.
All HKBU students or alumnus please submit his/her application form with membership fee ($30/year / $80/3 years / $110/5 years) to
Room 401J, Level 4, The Wing Lung Bank Building for Business Studies, Shaw Campus, 34 Renfrew Road Kowloon Tong, Hong
Kong, Membership fees cannot be refunded under any circumstances.
Members have to re-apply and pay HK$10 for a replacement membership card. The validity period for replacement membership cards
remains unchanged.
Members can renew their membership within three months prior to their membership expiry dates. The membership is valid from the
date of expiry. Data recorded in the membership card are re-writable. Members should bring along their membership card for the
renewal of membership.
For enquiries, please contact 3411 7826 / 3411 2327 or email to sa-uniy@so.hkbu.edu.hk
I acknowledge that personal information in this form can be transferred to Y’s Union, Alumni Association of University YMCA (Hong
Kong Baptist University), for communication purpose.
I hereby acknowledge that I have read and understood the above reminders and the membership policy appearing on the website of
Chinese YMCA of Hong Kong (www.ymca.org.hk).
Personal Information Collection Statement: Chinese YMCA of Hong Kong undertakes to comply with the requirements of the
Personal Data (Privacy) Ordinance to ensure that personal data kept are accurate and secure. Your personal information (including
your name, email address, etc) may be used by Chinese YMCA of Hong Kong for the purposes of sending you organizational updates,
fundraising appeals, event invitations, surveys and other communication and marketing via telephone/post/electronic mails. If you do
not wish to receive any communication from us, please email your Chinese and English full name, together with your
membership number and telephone number to uniycy@ymca.org.hk . For any enquiries, please contact us at 27052231.
Applicant’s Signature：
Date：
For official use only
Membership Fee：
□$30 □$80 □$110
Membership Card No.：
Centre： Uni-Y (HKBU)
Receipt No.：
Received by：
Date：
Updated: April 2015