Membership Application Form (Institution) Membership Application Form (Institution) 所提供之資料僅用作與會籍有關之事宜. The information provided will be used solely for membership related purposes.會員編號 Membership I.D. (續會用 For Renewal) For renewal, you only need to fill in the compulsory fields and those that require update. 除必須填寫的資料,續會會員可只填寫需要更新的資料。會費繳付 Payment會費 Membership fee: $500 會籍為期一年,自每年1月1日起至12月31日止。於6月30日以後加入的新會員, 只需支付一半年費。Membership lasts for one calendar year from 1 Jan to 31 Dec. New members joining after 30 June should pay one-half of the regular subscription rates.付款方法 Payment Method *支票 Cheque: 請以香港銀行支票支付予香港圖書館協會 Cheque must be made payable to Hong Kong Library Association and drawn on a bank in Hong Kong.入賬 Bank-in : 直接存入香港圖書館協會於香港匯豐銀行的戶口,戶口號碼:511-335846-838。Bank transfer to HKLA’s HSBC account (511-335846-838); 上傳或把入賬收據電郵至[email protected] Upload or email the bank-in receipt to [email protected].上傳入賬收據 Upload bank-in receipt 收據 Receipt需要 Yes你的會員卡將作為你的收據。 如需正式收據,請在方格內加上「✓」。 Your membership card will be your receipt. If a formal receipt is required, please check this box.機構資料 Organization Details機構名稱 Organization Name *英文 English機構名稱 Organization name in Chinese中文 Chinese機構地址 Organization Address城市 City國家 Country機構電郵地址 Organization Email *The Organization Email will be used for correspondence. 機構電郵地址將會用作會員通訊。機構電話 Organization Phone機構類別 Organization Category大學圖書館-教資會 Academic Library – UGC大學圖書館-非教資會 Academic Library – Non-UGC公共圖書館 Public Library學校圖書館 School Library專科圖書館 Special Library其他 Other聯絡人資料 Contact Person稱謂 Title 博士 Dr.小姐 Miss女士 Ms.先生 Mr.太太 Mrs.英文姓名 Name in English *SurnameGiven Name *Given name中文姓名 Name in Chinese職位 Position Held電郵 Email電話 Phone流動電話 Mobile傳真 Fax通訊地址 Mailing Address同上 Same as the Organization Address通訊地址 Correspondence Address Correspondence City城市 CityCorrespondence Country國家 Country會員電郵通訊錄 Members Email List不加入 Do not subscribe如你不願意加入會員電郵通訊錄,接收如招聘廣告、會議資訊、課程項目、特別優惠等電郵,請在方格內加上「✓」。 Please check this box if you do not want to be included in our members email list, through which we distribute messages such as job adverts, conference information, programmes and courses, special offers, etc.NameSubmit 提交