Donation Form 捐款登記

*Donors who make a donation of HK$1,000 or more will be acknowledged on the screen. Due to time constraint, only donations of HK$10,000 or above will be announced by MC during the Dinner (Calculated by the total amount of each supporting item). Thank you for your kind understanding.

捐款達到或超過港幣1,000 的捐贈者芳名將於屏幕上列出，唯因時間所限，司儀只能讀出捐款額達到港幣10,000或以上的捐贈者芳名（以每個支持項目的總額計算），懇請見諒。

Name of Donor / Organisation to be announced
捐贈者／機構名稱 *

Table No.
枱號 *

I / My Organisation hereby confirm to make a donation to support PolyU’s development through the following items.
本人 / 本機構謹此確認將透過以下項目，捐款支持香港理工大學的發展：

(A) Art & Culture Development 藝術及文化發展

1. Drumming Performance by Members of the Dinner Organising Committee
晚宴籌委會成員鼓樂表演

HK$

2. Singing Performance by Miss Cally Kwong, Mr Michael Wong & PolyU Choir
鄺美雲小姐、黃偉綸先生，及理大合唱團歌唱表演

HK$

(A) 藝術及文化發展小計 Subtotal: HK$ 0

(B) Student Development 學生發展

HK$

Total 捐款總額 HK$ 0

Contact Person
聯絡人

Tel
聯絡電話 (8位數字) *

Email
電郵地址 *

Terms and Conditions 條款及細则 *

I have read and understood the University’s Privacy Policy Statement and Personal Information Collection Statement.
本人已閱讀及明白大學的私隱政策聲明及收集個人資料聲明。 * By submitting this Donation Confirmation Form, I / my organization hereby confirm(s) to make a donation to PolyU and there are no conditions attached to this donation, and I understand that PolyU will contact me for donation payment settlement.
本人 / 本機構提交此捐款確認書，即表示本人 / 本機構確認向理大捐款，且此捐款不設任何附加條件，本人明白理大將聯絡本人安排付款。

Donation Form 捐款登記

Thank You for Your Generous Support!感謝您的慷慨捐助！

Thank You for Your Generous Support!
感謝您的慷慨捐助！