Alumni Donation Form

The Department of Chemistry is presently launching a fundraising program for the establishment of a new departmental fund named “Chemistry Alumni Fund” which is dedicated to a full-scale comprehensive support of our undergraduate students.

Donor particulars
Title *
Full name (Eng) *
Full name (Chi)
Degree completed *
Year of graduation *
Telephone *
Fax
Email *
Address *
Do you wish to remain anonymous? *
Donation details
Donor is *
Amount *
Please specify the amount (HKD) *
For overseas donors only (Please specify currency and amount) *

Overseas alumni may send personal or bank cheque.
Cheque number (6-digits) *

The six-digit number written at the bottom left-hand corner of the cheque is the cheque number.
Purpose *
Please put down your preferred Scholarship name (subject to endorsement by the Department Board of Chemistry) *
Note

Please make a crossed cheque payable to “The Chinese University of Hong Kong” and mark your name and telephone on the back of the cheque. The cheque should be sent to:

“Department of Chemistry, The Chinese University of Hong Kong, Shatin, N.T. Hong Kong, Attention to Ms. Felicia Wong”. Official receipt will be issued.
Disclaimer The personal data collected will be used by Department of Chemistry (CHM) and authorised personnel for processing the captioned purposes in accordance with relevant provisions of the Personal Data (Privacy) Ordinance.

Alumni Donation Form

Donor particulars

Donation details

Note