香港大會堂、香港文化中心 
Hong Kong City Hall & Hong Kong Cultural Centre
免費郵寄／電子郵寄每月節目表服務申請表
Application Form for Free Mailing / Emailing Service of Monthly Event Calendar
請在適當位置加「」。 Please put a ‘’ in the boxes provided as appropriate.
□	申請免費郵寄每月節目表服務

任擇其一 Either one

Apply for free mailing service of monthly event calendar
□	申請電子郵寄每月節目表服務
Apply for emailing service of monthly event calendar
□	更改個人資料／郵寄地址／電郵地址 （請註明更改前及更改後的資料）
Update personal particulars/ postal address/ email address (Please specify the information before and after the update)
□	取消免費郵寄每月節目表服務
Cancel the free mailing service of monthly event calendar
□	取消電子郵寄每月節目表服務
Cancel the emailing service of monthly event calendar

為免延誤申請程序，請清楚填寫本申請表格上的各項資料。你可將已填妥的表格－
To avoid any delay on the application procedure, all information on the application form should be completed clearly.  You may submit the completed form by- 
1.	郵寄或遞交至九龍尖沙咀梳士巴利道10號香港文化中心演藝大樓地下公關事務及節目部；或
Sending or mailing to Patron Services & Programme Section, G/F, Auditoria Building, Hong Kong Cultural Centre, 10 Salisbury Road, Tsim Sha Tsui, Kowloon; or
2.	
Ref. No. :                      (For office use only)

傳真到 2734 2053。	
fax to 2734 2053.

# 姓名Name :	*	先生Mr./ 太太Mrs./ 女士Ms./ 小姐Miss/ 其他，請註明Other, please specify:			

	姓氏Surname	名字First-name		
# 地址／電郵地址
Address/ Email Address:			
(任填其一 Either one)			

# 聯絡電話
Contact Telephone No.:											
		
*	請刪去不適用者。 Please delete as appropriate.
#	如欲更改資料，請提供及註明更改前及更改後的資料。 
 	If you would like to update the information, please provide and specify the information before and after the update.

個人資料(私隱)收集聲明
Notification of Personal Data Collection
1.	你所提供的資料將會用作郵寄香港大會堂或／及香港文化中心的節目資料或其他有助市場推廣的用途。
The information provided by you will be used for mailing of programme information of Hong Kong City Hall or/and Hong Kong Cultural Centre and for other related marketing purposes.
2.	本署可能會將部份資料給予其他政府部門以作上述用途。
The Department may disclose some of your information to other Government departments for the purposes mentioned above.
3.	除個人資料(私隱)條例所訂明的豁免外，根據同一條例第 18 及 22 條及附表 1 第 6 項原則，你有權要求查閱及更改本表格內所載列的個人資料。
Subject to exemptions under the Personal Data (Privacy) Ordinance, you have a right of access and correction of the personal data provided in this form.
4.	如欲更改或查詢個人資料，請致函給副經理（香港文化中心）公關事務及節目，其地址為九龍尖沙咀梳士巴利道10號香港文化中心演藝大樓。
Request for personal data access and correction should be addressed to the Assistant Manager (Hong Kong Cultural Centre) Patron Services and Programme, whose address is at Auditoria Building, Hong Kong Cultural Centre, 10 Salisbury Road, Tsim Sha Tsui, Kowloon.