PDF《新博物馆通行证 New Museum Pass》

会籍 Membership 1.

我选择申请 I would like to apply for#: 新博物馆通行证 New Museum Pass 博物馆通行证续期 Renewal of Museum Pass 旧证号码 Previous No.有效期至 Valid until: 补领博物馆通行证 Replacement of Museum Pass 旧证号码 Previous No. 若地址等资料不需更新,只需填写此表格所有适用的黄色方格项目. Only fill in applicable entries highlighted in yellow in this application form if other information such as address remains the same. 2. 博物馆通行证类别 Category of Museum Pass#: 个人通行证 Individual Pass 家庭通行证 Family Pass 优惠通行证 Concessionary Pass: 学生 Student (请附有显示现时为全日制学生的学生证或手册副本,个人八达通卡并不适用 Please enclose a copy of student I.D. card or handbook showing proof of current full-time student status, personalized Octopus card with Student Status is not accepted) 残疾人士 People with Disabilities (请附残疾人士登记证副本 Please enclose a copy of Registration Card for People with Disabilities) 高龄人士 Senior Citizen (请附长者咭或其他年龄证明文件副本 Please enclose a copy of Senior Citizen Card or other documents for age verification) 海洋公园「智纷全年入场证」持有人 Ocean Park SmartFun Annual Pass Holder (会员证号码 Membership No. (请附海洋公园「智纷全年入场证」副本 Please enclose a copy of Ocean Park SmartFun Annual Pass ) 香港迪士尼乐园「奇妙处处通」持有人 Hong Kong Disneyland Magic Access Holder (只适用於申请及续领全年博物馆通行证 Only applicable to new application and renewal of Museum Annual Pass) (请附香港迪士尼乐园「奇妙处处通」副本 Please enclose a copy of Hong Kong Disneyland Magic Access ) (会员卡号码 Membership No. 3. 有效日期 Period of Validity#: 全年 Annual 半年 Half Year (不适用於家庭通行证 Not applicable to Family Pass) 申请人资料 Applicant'

s Particulars 英文姓名 Name in English: (请用大楷填写 in BLOCK Letters) 姓氏 Last Name 名字 First Name 中文姓名 Name in Chinese: 联络电话 Contact Telephone No.: 性别 Sex# : 男Male 女Female 年龄 Age#: 4-11^ 12-15 16-20 21-25 26-30 31-40 41-59

60 or above

60 或以上 ^4 岁以下小童免费入场 Free admission for children under

4 years old # 请在适合的加?号Please put a ? in the appropriate box 家庭成员资料 Family Members'

Particulars (只适用於申请家庭通行证 Only applicable to Family Pass Applicant) 英文姓名 Name in English: (请用大楷填写 in BLOCK Letters) 姓氏 Last Name 姓氏 Last Name 姓氏 Last Name 名字 First Name 名字 First Name 名字 First Name 中文姓名 Name in Chinese: 性别 Sex# : 男Male 女Female 男Male 女Female 男Male 女Female 年龄 Age#: ^4 岁以下小童免费入场 Free admission for children under

4 years old 4-11^ 12-15 16-20 21-25 26-30 31-40 41-59

60 or above

60 或以上 4-11^ 12-15 16-20 21-25 26-30 31-40 41-59

60 or above

60 或以上 4-11^ 12-15 16-20 21-25 26-30 31-40 41-59

60 or above

60 或以上 与申请人关系(须为亲属) : Relationship with the Applicant (with kinship): 博物馆电邮通讯 Museum E-newsletter 我希望在我的博物馆通行证有效期内收到下列博物馆的电邮通讯 I would like to receive the E-newsletters of the following Museum(s) during the validity period of my Museum Pass # 香港艺术馆 Hong Kong Museum of Art 香港文化博物馆 Hong Kong Heritage Museum 香港科学馆 Hong Kong Science Museum 香港太空馆 Hong Kong Space Museum 香港历史博物馆/香港海防博物馆/孙中山纪念馆 Hong Kong Museum of History/Hong Kong Museum of Coastal Defence/Dr Sun Yat-sen Museum 电邮地址 Email Address: 我希望经电邮收到续证提示的通知服务 I wish to receive an email notification for the renewal of Museum Pass# 是Yes 不是 No # 请在适合的加?号Please put a ? in the appropriate box 个人资料(私隐)条例通知 Personal Data (Privacy) Ordinance Notification 申请人所提供的资料,只供申请康乐及文化事务署博物馆通行证及电邮通讯之用.申请人如附上身份证副本作年 龄证明文件,副本将会在核实后销毁.根鋈俗柿(私隐)条例,您有权要求查阅及更正所提供的个人资料.如对 填报个人资料有任何查询,请与有关博物馆经理联络. The personal data provided by means of this form will be used solely for the application of the Leisure and Cultural Services Department Museum Pass and E-newsletter. Photocopy of the ID Card, if provided for age verification, will be destroyed after use. The applicant has the right to request access to and correct his / her own personal data in accordance with the Personal Data (Privacy) Ordinance. For enquiries, please contact the Manager of the respective museum. 递交申请表格 Application Procedures 请填妥表格,亲身或寄回背页任何一间博物馆.如申请 「优惠通行证」 ,请出示有关证明文件或邮寄证明文件副本. 以邮寄形式递交申请表格,请填妥表格及填写本地通讯地址连同划线支票(抬头「香港特别行政区政府」),寄回背 页任何一间博物馆.如於递交申请表格后一个月仍未收到博物馆通行证,请致电有关博物馆查询. Please submit this duly completed application form to one of the Museums printed overleaf in person or by post. If you apply for Concessionary Pass , please provide supporting document or send the copy of supporting document by post. For postal application, please fill in the application form and input the correspondence address in Hong Kong together with a crossed cheque (payable to HKSAR Government ) to one of the Museums printed overleaf. If you have not received the Museum Pass in a month after you handed in the application, please contact the respective museum. 通讯地址 Correspondence Address (如用英文填写,请用大楷/in BLOCK Letters in English) (日期 Date) (申请人签署 Signature of Applicant) 博物馆全年/半年通行证持有人可享以下优惠 Privilege Offers for Museum Annual/ Half Year Pass Holder 1. 於博物馆通行证有效期内可无限次参观下列博物馆的展览厅/馆(部份专题展览除外) : 香港艺术馆、香港历史博物馆、香 港文化博物馆、香港科学馆、香港太空馆(何鸿鎏煜筇)、香港海防博物馆及孙中山纪念馆. 2. 於设在博物馆内的礼品店/书店购买康乐及文化事务署制作的刊物及纪念品可获九折优惠(孙中山纪念馆除外). 3. 参与博物馆主办的活动(如科学馆的电脑课程及以上博物馆的教育推广活动)可获九折优惠.参加活动费用倘为优惠价钱, 则不能同时享有此优惠. 4. 博物馆全年/半年通行证持有人申请海洋公园「智纷全年入场证」可获九折优惠. 5. 博物馆全年通行证持有人於优惠期内购买申请香港迪士尼乐园成人,小童/学生及长者「奇妙处处通」会员卡可分别获得 HK$50, HK$40 及HK$30 折扣优惠. 1. Unlimited admission during the validity period of the Museum Pass to the exhibition galleries/halls of following museums (excluding some special exhibitions): Hong Kong Museum of Art, Hong Kong Museum of History, Hong Kong Heritage Museum, Hong Kong Science Museum, Hong Kong Space Museum (excluding Stanley Ho Space Theatre), Hong Kong Museum of Coastal Defence and Dr Sun Yat-sen Museum. 2. 10% discount on purchase of souvenirs and publication produced by Leisure and Cultural Services Department at museum gift shops/book shops (except Dr Sun Yat-sen Museum). 3. 10% discount on participation in museum extension activities solely organized by the Museums (e.g. computer courses organized by the Science Museum and educational programmes organized by the above Museums). This discount is not applicable to fees which are already discounted under other concessionary schemes. 4. Museum Annual/Half Year Pass holders can enjoy 10% discount on Ocean Park SmartFun Annual Pass . 5. Museum Annual Pass holders can enjoy HK$50, HK$40 and HK$30 discount on Adult, Child/Student and Senior Magic Access of Hong Kong Disneyland respectively during the promotion period. 有效日期 Period of Validity 博物馆全年通行证 : 由发证日期起十二个月内 博物馆半年通行证 : 由发证日期起六个月内 Museum Annual Pass: Within