2019-2020年報

本人╱機構願意 I/We would like to □每月定期捐助 Donate on a monthly basis □作一次性捐款 Make a one-off donation 捐贈款項為 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 authorise 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 □ 存入本會戶口 1 Bank Direct Transfer 1 匯豐銀行 HSBC : 023-784457-838 。 □ 劃線支票 1 Crossed cheque 1 支票號碼 Cheque No.: (抬頭人請填寫「香港善導會」。 Please make cheque payable to “SRACP” ) □ 透過「 PayMe from HSBC 」捐款 3 Donation via “PayMe from HSBC” 3 掃描 QR 圖碼,並於付款訊息提供閣下的姓名、 電話及電郵地址。(毋需填交此回條) Scan QR code, provide your name, contact no. and email address at the message. (This form is not required.) □ 信用卡捐款(網上捐款) Donate by Credit Card (Online donation) 掃描 QR 圖碼或進入網址 donate.sracp.org.hk/ 。 (毋需填交此回條) Scan QR code or visit “donate.sracp.org.hk/” . (This form is not required.) 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「 3 」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 (852) 2527 4018 或電郵至 dpo@sracp.org.hk 與本會聯絡。 Your personal data collected in this form will be kept strictly confidential and made available only to SRACP for handling do nation 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 “ 3 ” 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 us at (852) 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 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. 3. 本會成功收到「 PayMe from HSBC 」交易紀錄後,將依照捐款者的訊息在七個工作天內發出正式收據。(港幣 $100 或以上的捐款) After successfully received the transaction on “PayMe from HSBC”, an official receipt will be issued according to the donor’s message within seven working days. (For donation of HK$100 or above) (本會為註冊擔保有限公司 Incorporated with limited liability by guarantee )

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