愛心地貧行2018 報名表格 Walk for Thalassaemia 2018 Enrolment Form

Please fill in all * Required blanks

機構 / 團體名稱 Organization Name (如屬個人報名, 則不需填寫 Please fill in the following if applicable.)

聯絡人姓名 Contact Person (先填姓氏 Surname First) *

稱謂 Title *

聯絡電話 Daytime Tel *

電郵 Email *

聯絡地址 Address *

請選擇參加組別及籌款人數 Number of Participants and Category * (請選擇一項 Please Choose One)

個人 Individual (每位參加者最低捐款額為HKD150 / Min. enrolment fee per participant is HKD150)

家庭/親友 Family/Friends (參加者 Participants: 2-4; 每位參加者最低捐款額為HKD150 / Min. enrolment fee per participant is HKD150)

家庭/親友 Family/Friends (參加者Participants: 5+; 每位參加者最低捐款額為HKD100 / Min. enrolment fee per participant is HKD100)

公司/機構/學校 Company/Organization/School (參加者Participants: 5+; 每位參加者最低捐款額為HKD100 / Min. enrolment fee per participant is HKD100)

總贊助額 Total Donation Amount *

如贊助人需索取收據，請列明姓名及捐款金額 Please fill in name of sponsors and donation amount if applicable. e.g. Chan Tin Man $100

大會將準備「愛心地貧行2018」証書予參與步行籌款人士，如需索取証書，請填上參加者姓名。”Walk for Thalassaemia 2018” certificate will be issued to participants with request, please fill in if applicable.

所有參加步行籌款人士，可獲贈地貧基金T恤一件、P&J索袋一個及其他精美禮品。Participant will receive a CTF T-Shirt, P&J drawstring bag and other walkathon souvenirs.

請選擇T恤的尺碼及填上件數 Please choose size of T-shirts

XS (胸寛 Width: 38cm 衣長 Length:56cm) 件數:

S (胸寛 Width: 43cm 衣長 Length:60cm) 件數:

M (胸寛 Width: 48cm 衣長 Length:65cm) 件數:

L (胸寛 Width: 53cm 衣長 Length:70cm) 件數:

XL (胸寛 Width: 58cm 衣長 Length:74cm) 件數:

※ 捐款收據及証書將於活動後在終點站派發 Certificate of participation and donation receipts will be distributed at the End Point.


 

完成捐款後，確認報名電郵將於三個工作天內寄出。

Enrolment Confirmation will be issued to you by email within 3 working days.

  • © Powered and Sponsored by Eventizer

  •