心之墨語 Ink from HEART

墨繪隨心而能感知。以墨讓思緒流淌、以藝與自我對話。

Ink flows with your heart, allowing a dialogue with yourself through the creative process in the here and now.

日期: 2024年11月2日 (星期六)
時間: 10:00 - 17:00
語言: 廣東話
活動內容：禪修及墨繪體驗
地點: 香港中文大學邵逸夫堂
名額: 40人
對象: 中大學生、教職員、校友及公眾人士 (Friends of the Arts 會員及中大本科生優先)
費用: 逸夫書院學生及Friends of the Arts會員($100)*; 其他中大本科生 ($100); 中大研究生、教職員及校友($380); 公眾人士 ($470)
*完成全日活動後可退回費用

截止報名日期:2024年10月20日 (星期日)

查詢：逸夫書院陳小姐 (irene-chan@cuhk.edu.hk / 3943 1549)

個人資料
Personal Information
身份 Identity

身份 Identity 逸夫書院學生 Student of Shaw College 其他中大本科生 Other CUHK Undergraduate Student 中大研究生 CUHK Postgraduate Student 中大職員 CUHK Staff 中大校友 CUHK Alumni 公衆人士 General Public
你是否Friends of the Arts 會員？
Are you a member of Friends of the Arts?

你是否Friends of the Arts 會員？
Are you a member of Friends of the Arts? 是 Yes 否 No
稱謂 Title (Mr./ Ms./ Mrs./ Miss)
英文全名 English Full Name
中文全名 Chinese Full Name
(Please input N/A if not applicable)
學生編號 Student ID
(Please input 0 if not applicable)
主修 Major
學科 Postgraduate Programme
就讀年級 Study Year
職位 Position
部門 Department
畢業年份 Graduation Year
所屬書院 College
聯絡電話 Contact No.

If you do not have a local mobile number in HK, please input your whatsapp number together with the region code for contact.
電郵 Email
付款證明 Proof of Payment

戶口名稱 Account Name: The Chinese University of Hong Kong
銀行名稱 Name of Bank: Hang Seng Bank Limited
銀行戶口號碼 Bank Account No.: 293-005005-018 (HKD)
銀行代碼 Bank Code: 024

請上載你的付款證明 Please upload your payment proof here

Attach Files

客戶通知書/屏幕截圖/過數紙 (請確保金額清晰顯示)
customer advice / screen capture / payment slip (Please ensure the amount is clearly shown)
如銀行轉賬戶口非參加者本人, 請列明轉賬人戶口姓名, 以供核對交易紀錄
If payment via bank transfer from third party bank account, please provide the bank account holder name for checking the payment transaction.

如銀行轉賬戶口非參加者本人, 請列明轉賬人戶口姓名, 以供核對交易紀錄
If payment via bank transfer from third party bank account, please provide the bank account holder name for checking the payment transaction. 參加者本人 Same as participant 非參加者本人 Third Party (Please provide name)
銀行資料 (退回活動費用)
Bank Account Information (For programme fee refund)
銀行名稱 Name of Bank
銀行戶口號碼 Bank Account Number
(e.g. 292-123456-789 add '-' instead of the space)
戶口持有人名字 Name of Account Holder (e.g. Chan Tai Man)
個人資料（私隱）收集聲明：
參加者所提供的資料只供書院作安排活動之用，如需查閱及更正有關資料，請與書院職員陳小姐聯絡（電話︰3943-1549／電郵︰irene-chan@cuhk.edu.hk）。

Personal Data Collection Statement:
The personal data you provided in the form will only be used for the above-mentioned activity. For access to or correction of personal data submitted, please contact Ms. Chan of Shaw College (Tel: 3943-1549 / E-mail: irene-chan@cuhk.edu.hk).
Declaration:

Declaration: 若報名後退出，活動費用將不獲退還。The programme fee/ subsidy would not be refunded for withdrawal after registration. 主辦方保留於活動前或進行期間更改活動安排而無須作另行通知。 We reserve the right to change or modify the programme arrangement without prior notice. 本人已經詳閱有關活動的報名須知及個人資料(私隱)收集聲明，並且謹此同意遵守。本人聲明報名表內所提供之個人資料，根據本人所知，均正確無訛，亦明白若提供的資料不清楚或不齊全，本人的報名將不獲處理。 I have read and agree with the registration guidelines and the Personal Data Collection Statement. I hereby declare that the information I provided in this application form is complete and true to the best of my knowledge. I understand that my registration will not be considered if I fail to provide all information as requested.
報名結果將以電郵形式公佈。 Registration results will be announced by email.
Disclaimer The personal data collected will be used by Shaw College and authorised personnel for processing the captioned purposes in accordance with relevant provisions of the Personal Data (Privacy) Ordinance.

心之墨語 Ink from HEART

個人資料 Personal Information

銀行資料 (退回活動費用) Bank Account Information (For programme fee refund)

個人資料
Personal Information

銀行資料 (退回活動費用)
Bank Account Information (For programme fee refund)