牛池灣文娛中心
免費郵寄／電子郵寄每月節目表服務申請表
Application Form for Free Mailing / Emailing Service of 
Monthly Event Calendar of Ngau Chi Wan Civic Centre
請在適當位置加“” Please put a “  ” in an appropriate place

  申請免費郵寄每月節目表服務
	Apply for free mailing service of monthly event calendar   

任擇其一 Either one 

  申請免費電子郵寄每月節目表服務
Apply for free emailing service of monthly event calendar

  更新個人資料/郵遞地址/電郵地址
	Update personal particulars/ postal address/ email address 

  取消免費郵寄每月節目表服務
	Cancel free mailing service of monthly event calendar

  取消免費電子郵寄每月節目表服務
Cancel free emailing service of monthly event calendar

請填妥表格寄回：香港九龍清水灣道11號牛池灣市政大廈2樓牛池灣文娛中心;或傳真至2320 2684
或電郵至ncwccmkt@lcsd.gov.hk。(查詢電話：2325 1970)
Please send the completed form to: Ngau Chi Wan Civic Centre, 2/F, Ngau Chi Wan Municipal Services Building, 
11 Clear Water Bay Road, Kowloon, Hong Kong; or fax to 2320 2684 or email to ncwccmkt@lcsd.gov.hk. (Enquiries: 2325 1970)
	Ref. No. :                   (For office use only)	
	
姓名Name：
																									
	英文English (姓氏在前Surname first)
	
					 * 先生/太太/女士/小姐 Mr/Mrs/Ms/Miss	
	中文Chinese		
			
地址/
新地址 :
Address /
New Address :																									

		
地區District :
															* 地域：香港/九龍/新界	
		Region:  HK / KLN / NT	
		
聯絡電話 :
Contact Tel. No.										

電郵Email :																									
		
*請刪去不適用者  Please delete as appropriate

個人資料(私隱)收集聲明

i)	你所提供的資料將會用作分發本中心的每月節目表或其他市場推廣的用途。
ii)	康樂及文化事務署可能會將部份資料給予其他政府部門以作市場推廣用途。
iii)	除個人資料(私隱)條例所訂明的豁免外，根據同一條例第18及22條及附表1第6項原則，你有權要求查閱
	及更改本表格內所載的個人資料。
iv)	如欲查詢或更改個人資料，請致函給副經理(九龍東)市場推廣及地區活動，其地址及電話號碼載於本表格上。

Notification of Personal Data Collection

i)	The information provided by you will be used for sending the monthly event calendar of Ngau Chi Wan Civic Centre 
	and for other marketing purposes.
ii)	The Leisure and Cultural Services Department may disclose some of your information to other government departments 
	for marketing purposes.
iii)	Subject to exemptions under the Personal Data (Privacy) Ordinance, and in accordance with Section 18 and 22 and Principle 6
	of Schedule 1 to the Ordinance, you have a right of access and correction of the personal data provided in this form.
iv)	Request for personal data access and correction should be addressed to Assistant Manager (Kowloon East) Marketing and	 District Activities, whose address and telephone number indicated above.