如需捐款收據申請美國扣減稅項，請參閱此 。

For donor who requires an official receipt for tax exemption in the U.S., please please visit here.

捐款詳情  DONATION DETAILS

捐款意願  Donation Purpose *
捐款次數  Donation Frequency *

捐款金額  Donation Amount *
(以港幣折算) (Denominated in Hong Kong dollars.)
如捐款港幣一百萬港元或以上，請與中大眼科聯絡。Please contact DOVS CUHK for donation more than HK$1,000,000.
捐款方法 Donation Method*
直接存入香港中文大學之銀行戶口 (恒生銀行戶口號碼：293-005005-003)
Direct deposit into the bank account of CUHK (Hang Seng Bank Account Number: 293-005005-003)
劃線支票 (祈付「香港中文大學」)
Crossed Cheque (Payable to "The Chinese University of Hong Kong")
轉數快
By FPS
信用卡 (接受VISA、萬事達卡或銀聯卡)
Credit Card (VISA, MasterCard or UnionPay are accepted)

捐款者資料  DONOR PARTICULARS

捐款名義 Donation Type*

捐款者 Donor
稱謂 Title*
姓氏 (中文) Last Name (Chinese)
名字 (中文) First Name (Chinese)
姓氏 (英文) Last Name (English)*
名字 (英文) First Name (English)*
電話 Phone Number*
電郵 E-mail*
郵寄地址 Mailing Address

如需大學發出適用於加拿大申請扣減稅項之捐款收據，請填寫  閣下位於加拿大之地址。
If you would like to receive tax-deductible receipt applicable in Canada, please provide your Canadian address.

地址 (行 1) Address (Line 1)*
地址 (行 2) Address (Line 2)*
地址 (行 3) Address (Line 3)
地址 (行 4) Address (Line 4)
郵區編號 (海外地址適用)
Postal Code (applicable for overseas address)
國家或地區 Country / Region*

捐款收據  DONATION RECEIPT

請將捐款退稅收據郵寄至本人的通訊地址。
Please send the tax-deductible donation receipt to my mailing address.
本人不需要捐款退稅收據。
Donation receipt is not required.
捐款港幣一百元或以上可獲香港中文大學發出適用於香港申請扣減稅項之正式收據。
Tax-deductible receipt applicable in Hong Kong will be issued by CUHK for donors who have made a donation in the amount of HK$100 or above.
所有捐款須通過香港中文大學校董會批准接受。如捐款不獲接受，有關捐款將退回予捐款人。
Acceptance of donation is subject to the approval of the University Council of the Chinese University of Hong Kong . All unaccepted donation will be returned to respective donor.

捐款鳴謝  DONATION ACKNOWLEDGEMENT

我願意接受捐款鳴謝。
I accept donation acknowledgment.
我希望以匿名者身份捐款。
Please keep this donation anonymous.

推廣  PROMOTION

本人不同意中大眼科使用本人的個人資料向本人進行籌募或活動宣傳。
I do not wish to be contacted by DOVS CUHK for direct marketing purpose.

聲明  DISCLAIMER

收集個人資料

閣下在捐款表格所提供的個人資料(包括姓名、聯絡資料、校友資料及捐款紀錄)將用作與捐款有關的各種目的，包括保存捐款紀錄及呈報香港中文大學有關部門。閣下有權要求查閱及更改提供予中大眼科的個人資料。如閣下欲行使這項權利，請將要求電郵或郵寄至香港中文大學眼科及視覺科學學系 – 行政處。
地址：香港九龍亞皆老街147K號香港眼科醫院4樓
電郵：deptovs@cuhk.edu.hk.

Collection of Personal Information

Your personal data including your name, contact information, alumni information and donation information provided in this form will be used for the purpose of donation record keeping and reporting to the concerned units of The Chinese University of Hong Kong. You have the right to request access to and (if appropriate) correction of personal data held by DOVS. If you wish to exercise this right, please write to the Administration Division, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong.
Address: 4/F, Hong Kong Eye Hospital, 147K Argyle Street, Kowloon,
Email: deptovs@cuhk.edu.hk