2018 - 2019 年報

本人╱機構願意 I/We would like to □ 每月定期捐助，捐贈款項為 Donate on a monthly basis with the following amount: □港幣 HK100 　□港幣 HK$300 　□港幣 HK$500 　□港幣 HK$1000 　□其他 Other Amount ：港幣 HK$ □作一次性捐款，捐贈款項為 Make a one-off donation with the following amount: □港幣 HK100 　□港幣 HK$300 　□港幣 HK$500 　□港幣 HK$1000 　□其他 Other Amount ：港幣 HK$ ( 如捐款予指定服務 / 計劃，請註明 Please specify for designated service/scheme: ) 每月捐款 Monthly Donation □信用卡每月捐款 Credit card monthly debit 信用卡種類 Credit Card Type □ Visa □ Master 信用卡號碼 Credit Card Number 信用卡持有人姓名 Cardholder’s Name 信用卡有效期至 ( 月 / 年 ) Card Valid Date (MM/YY) □ 本人現授權香港善導會由本人之信用卡賬戶定期扣除上述賬款，直至另行通知為止。本人同意此授權書於本人之信用卡有效期屆滿後及獲續發新卡 時繼續生效，毋須另行填寫授權書。（如需要取消或更改本授權書，請於取消或更改生效日期七個工作天前通知香港善導會。） I hereby authorize SRACP to charge my credit card account for the amount specified in a regular manner as agreed upon by me and SRACP until further notice. I agree the validity of this agreement will continue before or after the expiry date of my credit card account. (Notice of cancellation or variation of this authorisation shall be given to SRACP seven working days before the date on which such cancellation or variation takes effect.) 信用卡持有人簽署 Credit Cardholder’s Signature 一次性捐款 One-off Donation □ 透過本會網站 www.sracp.org.hk 的「網上捐款」功能以信用卡捐 款。掃描右邊 QR code 即進入捐款網站。 ( 網上捐款不用填交此回條 ) Donate through our website www.sracp.org.hk by credit card. Scan QR code to visit our donation site. (You need not return this form for online donation.) □ 劃線支票，抬頭人請填寫「香港善導會」。 1 Cheques should be crossed and made payable to “The Society of Rehabilitation and Crime Prevention, Hong Kong”. 1 銀行名稱 Bank: 支票號碼 Cheque No.: □ 直接存入本會戶口：香港上海滙豐銀行 110–8–011741 。 1 Deposit directly to the Society’s bank account, HSBC Account No.: 110–8–011741. 1 致 : 香港善導會 香港灣仔軒尼詩道 15 號 溫莎公爵社會服務大廈 603 室 To: The Society of Rehabilitation and Crime Prevention, Hong Kong (“SRACP”) Room 603, Duke of Windsor Social Service Bldg., 15 Hennessy Road, Wanchai, Hong Kong 捐款表格  Donation Form 捐款者資料 Donor’s Information （ * 為必須填寫項目 *denoted mandatory fields ） 善長芳名或機構名稱 Name of Individual or Organisation: （中文 Chinese ） ( 英文 English) （先生 Mr. / 女士 Ms. ） 聯絡人 Contact Person: （先生 Mr. / 女士 Ms. ）職銜 Position: 聯絡電話 Tel* ： 傳真 Fax: 電郵 E-mail* ： 郵寄地址 Mailing Address （住宅 Residential / 公司 Office ） □本人╱機構需要收據以作申請扣稅之用。 2 Please send me/us an official receipt for tax deduction. 2 個人資料收集聲明 Personal Information Collection Statement 本表格所收集的個人資料將嚴格保密處理，並只會給予香港善導會用於籌募相關事宜、發出收據及作出鳴謝。根據《個人資料（私隱）條例》，你有權 隨時查閱和更改香港善導會持有關於你的個人資料。香港善導會擬使用你的個人資料（即你的姓名和聯絡資料）進行慈善募捐以及活動和服務聯絡 前，必須先行取得你的同意，若你不希望收到本會任何通訊，或只希望透過郵寄╱電子郵件收到通訊，請在以下空格加上「  」號。 □郵寄 □電子郵件 □不接收任何通訊 有關個人資料的查詢及更新，或日後欲停止收到香港善導會的推廣資訊，請致電 2527 4018 或電郵至 dpo@sracp.org.hk 與本會資料保障主任聯絡。 Your personal data collected in this form will be kept strictly confidential and made available only to SRACP for handling donation matters, issuing receipts and making acknowledgments. Under the Personal Data (Privacy) Ordinance, you have the rights of access and corrections with respect to your personal data held by SRACP and SRACP should obtain your prior consent if it intends to use your personal data (i.e. your name and contact details) for soliciting donations and keeping you informed of its activities and services. (If you DO NOT wish to receive any communications from SRACP, or only receive communications via post or email, please put a “  ”in the appropriate box/boxes below.) □ Only by post  □ Only by email  □ No communications If you want to enquire on or update your personal data, or do not wish to receive any promotional materials from SRACP, please contact our Data Protection Officer at 2527 4018 or by email dpo@sracp.org.hk . 簽署 Signature: 日期 Date: 備註 Remarks 1. 請將支票或銀行入數紙正本或便利店收據正本連同此表格一併寄回本會，以便發出正式收據（如需要者）。 Please send the cheque or bank-in slip or receipt from convenience stores together with this form to the Society for issuance of donation receipt, if required. 2. 港幣 $100 或以上的捐款可申請減稅。每月捐款的正式收據將於每年四月寄奉。 Donation of HK$100 or above is tax deductible. For monthly donations, an official receipt will be issued in April annually. （本會為註冊擔保有限公司 Incorporated with limited liability by guarantee ）