Leisure and Cultural Services Department’s Civic Centres Booking Application Form (Minor Facilities)
Music Studio / Dance Studio / Conference Room / Lecture Room / Practice Room * Tuen Mun Town Hall

Important Notes :
(1)	
For Office Use Only

Hirer I.D.	: ________________

Appn I.D.: _____ __________

This booking application will be considered by the Leisure and Cultural Services Department.	
(2)	Please read the Booking Arrangements before completing this application form.	
(3)	For functions involving public exhibition of films as defined in section 2 of the Film Censorship Ordinance, Cap.392, a Certificate of Approval/Exemption is required from the Film Censorship Authority.  Please contact Office for Film, Newspaper & Article Administration for details.  Applicant should also note that they need to comply with any requirements set out in other Ordinances as may be applicable to their function(s), such as those in the Control of Obscene and Indecent Articles Ordinance Cap 390 and the Summary Offences Ordinance Cap 228.	

PART I
Section A	(To be completed if Applicant is an individual)
Name of Applicant	Mr. / Ms. *		(English)		(Chinese)	
Hong Kong Identity Card No. / Passport No. *(Please fill in the first 4 characters, e.g.A123456(7)→A123)
(Note: You may be required to produce your identification document to venue staff for verification.)	

	
	
Address		
Tel		Fax		Email		
Section B	(To be completed if Applicant is an organisation)
Name of Organisation		(Registered English Name)	
		(Registered Chinese Name)	
Nature of Organisation	 Commercial                     Non-commercial                    Government Bureau / Department	
Form of Registration	 Business Registration	 Charitable Institution or Trust of a Public Character (under Inland Revenue Ordinance)	
	 Registered under Companies Ordinance	 Registered under Societies Ordinance		
	 Registration of a School	 Others: 								
Address of Organisation		
Name of Signatory	Mr. / Ms. *		(English)		(Chinese)	
Position Held by Signatory		
Tel		Fax		Email		

PART II

Facilities	Date (dd/mm/yy)	Time	
 Music Studio
 Dance Studio
 Conference Room
 Lecture Room (1)
 Lecture Room (2)
 Practice Room (1)/(2)/(3)	1st choice			
	2nd choice			
	3rd choice			

PART III
Name of Event		(English)	
		(Chinese)	
Nature of Event			
Details of Event	(e.g. theme, title, programmes and name of artists / speakers, etc. Please specify the country of origin if there are any artists/speakers who are non-HK residents)	
	
Commencement Time of Function	Estimated No. of Participants		
Use of URBTIX Service	 Yes	 No	Admission Fee	$                    / Free*	
Any sale of merchandise during the event?    Yes / No*    If yes, please specify the merchandise items at below:	
	
For exhibitions, please attach catalogues of past exhibitions.	
	
Name of sponsor(s) (if any)		
Name of co-presenter(s) (if any)		

Use of e-Payment
Settle hire charges through e-Payment if application is approved (e-Payment refers to online payment service by means of PPS/Credit Card) :
 Yes     No	
If yes, please provide your email for receiving the password for using e-payment service:                               
(if different from Part I above)                                                  	

PART IV (For Special Booking Application only)
Reason(s) why this booking needs confirmation more than 7 months in advance: (Please attach documents to support the information given above)	
	
PART V
If you are interested in applying for the hire charges reduction, please read the guidelines on Hire Charges Reduction Scheme and then complete the following:
Will you apply for the Scheme?   Yes / No*            The event is open / not open* to the public.
(Please complete a separate application form for Hire Charges Reduction Scheme to apply for in the Scheme.)

PART VI
Person to contact regarding detailed arrangements of the event	
Name of Contact Person	Mr. / Ms. *		(English)		(Chinese)	
Address		
Tel		Fax		Email		

Declaration
I, the authorised representative of the applicant/organisation, hereby declare that all information and documents submitted by me in support of this booking application are update, valid and subsisting with regard to the legal status of the applicant/organisation, and I undertake to provide any further information and documents in respect of any changes thereto.
I understand that I may be liable to be prosecuted should any false information and/or invalid documents be provided in this booking application.	
Chop of Organisation Represented:		
	Signature：		
	Name of Applicant / Signatory*：		
	Date：		

*Delete if inapplicable            Tick if appropriate

Notices Regarding the Personal Data (Privacy) Ordinance

Purpose of Collection	(1)	The personal data provided by means of this application will be used by the Leisure and Cultural Services Department for the following purposes :
(a) Processing of booking applications for the Tuen Mun Town Hall hiring facilities; 
(b) Communication in the normal course and in case of emergencies; 
(c) For statistics and research purposes on the condition that the resulting statistics or results of the research will not be made available in a form which will identify the data subjects or any of them; and
(d) Any other legitimate purposes as may be required, authorised or permitted by law.	
	(2)	The provision of personal data by means of this application is voluntary.  However, if insufficient information is provided, the application / request may be delayed or not be considered or processed.	
Classes of Transferees	(3)	The personal data you provide by means of this application may be disclosed to Government bureaux, departments and other organisations for the purposes mentioned in paragraph 1 above.	
Access to Personal Data	(4)	You have a right to request access to or the correction of your personal data as stated in this application in accordance with Sections 18 and 22 and Principle 6 of Schedule 1 to the Personal Data (Privacy) Ordinance.	
Enquiries	(5)	Enquiries concerning the personal data collected by means of this application, including the request for access and correction, should be addressed to Manager (Tuen Mun Town Hall) Operations at (852) 2450 4421 (Tel) or (852)2451 6335 (Fax).	

Booking Enquiries: 2450 7775 / 2450 7875   Fax: 2451 6335
(Monday to Friday from 9am to 5:45pm (except public holidays))