香港文化博物館
HONG KONG HERITAGE MUSEUM
豁免入場費申請表
Application for Free Admission
 申請編號
傳真Fax : 2180 8111												 Application No.              

( 請先閱讀申請須知  Please read the Notes on Application before completion )
註冊非牟利機構 / 註冊慈善團體 / 學校豁免入場費申請
Application for Waiver of Admission Charges for Advanced Booking by Registered Non-profit-
making Organization / Registered Charitable Organization / School	

  團體 / 學校名稱 ( 中文 ) 

                                                           	 Name of Organization / School (English)

  團體 / 學校性質Nature of Organization / School  (● 請附上申請須知所列的證明文件副本 )
                                             (●Please enclose copy of supporting documents as specified in the Notes on Application )
□	● 註冊非牟利團體Registered Non-profit-making Organization
□	● 註冊慈善團體Registered Charitable Organization
□	學校： 中學 / 小學 / 其他 (請註明)  School: Secondary/Primary/Others (please specify)                    

  團體 / 學校地址Address of Organization / School

	

  活動負責人姓名Name of Person-in-charge    * Mr. / Miss / Ms / Mrs.

  (English)							(中文)	  聯絡電話 Contact Telephone No.
	
	  傳真 Fax No.	
逢星期一休館 Closed on Mondays  日期 Date                           日期 Date                  
申請參觀日期及時間
Date & Time of Visit	  第一選擇 	    時間 Time
   1st Choice	   第二選擇  時間 Time
   2 nd Choice                                                 	

 參觀人數 Number of Participants	   年歲 Age
 	  (學校適用 For School)  年級 Form

 隨行工作人員 / 教師數目 Number of Accompanying staff / Teachers
	  總人數 Total Number of Visitors

 為參觀本館，有否向團員額外收入場費？
 Do you charge members for admission to the Museum?	沒有  No	/	有   Yes    $	
茲證明所填報的資料均正確無訛，並無遺漏。(須由團體負責人，例如主席、總理、行政秘書等簽署，或學校負責老師簽署)
The undersigned hereby certifies that all the information furnished on this form is complete and accurate.  (To be signed by an officer or responsible position in the organization, such as the Chairman, Director, General Secretary, etc. or the teacher-in-charge)
 姓名 Name	 職位 Post

 簽署 Signature
 	  日期Date
 
	  團體 / 學校印鑑
  Organization / School Chop	

此欄由本館填寫 For Official Use Only						  Date received :                          
Handled by:
Application approved*/not approved* (Reason for disapproval:                                           )

Confirmed date of visit:                              Confirmation letter sent on:                      

申請豁免入場費須知
1.	豁免入場費優惠，專為學校、註冊慈善機構及註冊非牟利機構二十人或以上的參觀而設，不適用於其他團體參觀。而少於二十人的團體須繳付入場費。

2.	香港文化博物館開放時間為星期二至四、六及日上午十時至下午六時，星期五上午十時	至下午九時，逢星期一、農曆年初一、初二休館。逢星期三免費入場。

3.	申請人須於距離申請參觀日期最少兩星期前遞交申請表 (只接受申請參觀日期起計三個月內的申請，星期六、日及公眾假期之申請，將不獲優先考慮)。

4.	申請豁免入場費優惠的團體必須已根據社團條例或公司條例註冊立案，或已根據法例成
立，或已註冊為認可慈善機構或公共性質的信託團體。在申請團體的章程或組織章程大綱及章程細則，或有關條例或信託契約中，必須明文規定，若團體解散，其成員不得分享利潤或資產。

5.	註冊慈善團體及註冊非牟利機構於遞交申請時，請附上有關之證明文件副本以證明其慈
善性質或非牟利性質。證書副本必須由機構負責人正式簽署，連同團體蓋印，以示真確。

6.	填妥的申請表連同證明文件副本，可傳真(2180 8111)或郵寄回沙田文林路一號香港文化
博物館，信封面請註明「申請豁免入場費」。

7. 	如當天參觀團體眾多，本館將因應博物館各展廳可容納人數，按先到先得方法批准參觀申請。

8.	申請如獲批准，館方將致函覆實。申請人須於入場時出示該書面證明。如於距離參觀日
期兩星期前仍未獲回覆，請與本館職員聯絡 (查詢電話：2180 8188) 。

9.	如申請資料有任何更改，申請人須於距離參觀日期至少一星期前通知館方作適當安排；
如改動違反上述任何申請原則，或申請人未經許可擅自更改已批核的資料，館方有權隨時取消批准，並按實際情況索回入場費。

10. 	本館發出批准書後，若申請人欲更改參觀日期、時間、人數或參觀安排，必須重新申請。

11. 	關於各項申請，香港文化博物館擁有絕對決定權。申請能否獲得批准，須視乎申請人是否完全符合上述條件而定。如申請人不遵守以上規定或提供虛假的資料，館方有權取消批准及索回全部入場費。

12. 	根據個人資料 (私隱) 條例第十八、二十二及附表一載列的第六原則，申請人有權要求
查閱及更正表格內所提供的個人資料。申請人於表格內所提供之個人資料將會存檔於本館作記錄。申請人如欲查閱及更正本表格所收集的個人資料，請致電香港文化博物館與本館職員聯絡（電話：2180 8188）。

Notes on Application for Free Admission

1.	Application for waiver of admission charges is open to groups of 20 or more visitors from schools, registered charitable organizations and registered non-profit-making organizations only.  Groups less than 20 are required to pay for the admission charges.
2. 	The opening hours of the museum is : 10am to 6pm (Tuesday to Sunday), 10am to 9pm (Fridays).  Closed on Mondays and the first two days of the Lunar New Year.  Free Admission on Wednesdays.
3. 	The applicant is required to submit the completed application form at least 2 weeks in advance of the intended date of visit.  (Application is accepted up to 3 months in advance and priority will not be given to applications on Saturdays, Sundays and Public Holidays.) 
4. 	The applicant for waiver of admission charges should be registered under the Societies Ordinance or incorporated under the Companies Ordinance or formed by statute or registered on the list of approved charitable institutions or trusts of a public character.  Its Constitution or Memorandum and Articles of Association or Ordinance or Trust Deed should specifically provide that members do not take any share of the profits nor any share of the assets upon dissolution.
5. 	For registered charitable organization or registered non-profit-making organization, applicant should produce copies of supporting documents to identify the charitable nature or non-profit-making nature of the organization.  The copies should be certified true by an authorized officer together with the organization chop. 
6. 	Please fax (2180 8111) or return by mail (please mark “Application for Waiver of Admission Charges” on the envelope) the completed application form together with copies of supporting documents to the Hong Kong Heritage Museum, 1 Man Lam Road, Sha Tin.
7. 	If there is a large amount of group visitors within one day, application will be accepted on a first-come-first-served basis, according to the capacity of various galleries.
8. 	Successful application will be confirmed by letter and the applicant is required to produce the letter upon admission.  If no reply is received from the Museum 2 weeks before the date of visit, please contact the Museum staff at Tel: 2180 8188.
9. 	Should there be any alterations regarding the visit, please notify the Museum at least 1 week before the date of visit for necessary arrangement.  If the change violates the above criteria or the applicant changes the agreed information without prior permission of the Museum, the Museum reserves the right to refuse permission and recover the appropriate amount of admission charges.
10. 	New application is required for any change of the date and time of visit, the number of visitors and arrangement of the visit.
11. 	The Museum reserves the right to decide whether to approve an application.  All applications are approved subject to the applicant’s absolute compliance with the above-mentioned criteria.  If the applicant fails to observe this condition or any information provided by the applicant is found to be untrue, the Museum reserves the right to withdraw the approval and recover the full amount of admission charges waived.
12. 	You have the right to request access to and to request the correction of personal data as stated in this form in accordance with Section 18, 22 and Principle 6 of Schedule 1 to the Personal Data (Privacy) Ordinance.  The personal data you provide by means of this form will enter the record of the Museum.  Enquiries concerning the personal data collected by means of this form, including the request for access and corrections, should be addressed to Hong Kong Heritage Museum, 1 Man Lam Road, Sha Tin. Tel. No: 2180 8188.