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童軍知友社 賽馬會朗屏青少年服務中心 電子會員申請表
The Friends of Scouting Jockey Club Long Ping Service CentreChildren & Youth
Membership Application Form
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* Indicates required question
本人欲申請成為中心會員(I am applying for the membership of)
*
少年會員 (6-11歲)，申請須得到家長/監護人同意及簽署，請親臨本中心辦理手續
少年會員/Children (12-14歲)
青年會員/Youth (15歲或以上)
家長會員 (必須為已申請本中心少年會員/青年會員之家長)/Parent(Children/Youth member's parents)
中文姓名 (Chinese Name)
*
Your answer
英文姓名 (English Name)
Your answer
出生日期 (Date of Birth)
*
MM
/
DD
/
YYYY
年齡 (Age)
*
Your answer
性別 (Gender)
*
女 (Female)
男 (Male)
手提電話 (Mobile No.)
*
Your answer
住宅電話 (Telephone No.)
Your answer
通訊地址 (Residential Address)
Your answer
電郵地址 (E-mail Address)
*
請填寫正確的電郵地址，電子會員證將發送至以下電郵地址
Your answer
就讀學校或機構名稱 (Organization/ School)
Your answer
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