【小組活動資助申請表】聯合書院岑才生學長計劃：2025-2026 何萬森學年【Group Activities Sponsorship Reimbursement Form】UC Shum Choi Sang Mentorship Programme: Year of Ho Man Sum 2025-2026

▶申領活動贊助費指引◀

• 書院於每學年贊助最多兩次小組活動費用（上、下學期各一次），惟每次活動必須有最少兩名同組學長出席，贊助金額為每位小組成員上限港幣五十元，實報實銷。

• 申領小組活動贊助費(逾期申請將不獲受理)：
上學期資助申請須於2025年12月31日或以前提交；
下學期資助申請則須於2026年7月31日或以前提交。

▶Group Activity Sponsorship Guidelines◀

• The college will provide sponsorship (Max. HK$50/head, reimbursed upon actual expenses) to group at most twice a year (once per term) after organising group activities. At least TWO mentors in the same group must be presented in group activities.

• Reimbursement Submission Deadline (Overdue will not be accepted):
1st Term: 31 December 2025
2nd Term: 31 July 2026

查詢 Enquiry:
Ms Chillies Tam (3943-1948/chilliestam@cuhk.edu.hk)
Ms Kate Chau (3943-7582/katechau@cuhk.edu.hk)
Ms Ming Lee (3943-7598/minglee@cuhk.edu.hk)

A. Personal Particulars

Please provide basic contact information.
Group no.
Identity

Identity Mentor Mentee
English Full Name
Chinese Full Name
SID no.
Phone no.
Email
B. Payment Method

Please select payment method and provide necessary information for reimbursement.
Payment Method

Payment Method Bank Autopay Crossed Cheque
Bank Name
Bank Account No.
Account Holders' Name (as shown in bank account)
Payee Name (as shown in bank account)
Mailing Address (for cheque delivery)
C. Expenditure Information

Please provide details of your group activity and its related expenses.
Event Date Event Date / MM / DD YYYY
Group Activity/Venue
Amount to be reimbursed (HKD)
(Max. HK$50/head, reimbursed upon actual expenses)
No. of Participants (Mentor)
List of Participants (Mentor)
*Please provide mentors' FULL names*
No. of Participants (Mentee)
List of Participants (Mentee)
*Please provide mentees' FULL names*
D. Mentor/Mentee's Sharing (Sharing will be posted on college website/social media)

Anything you would like to share? / What’s your most unforgetable moment in this activity? (within 50 words)
Mentor/Mentee's Sharing
E. Supporting Documents

Please upload 1) Receipts, 2) 2-3 group activities photos which participants were shown
Upload Supporting Documents

Attach Files
F. Declaration
I declare that the above information is correct, and the expenses follow the guidelines of this sponsorship.

I declare that the above information is correct, and the expenses follow the guidelines of this sponsorship. Agree
College Staff will contact you if there is any problem with your application. Otherwise, reimbursement will usually take 1-2 months to process.

For bank autopay, please check your bank statement 1-2 month after submitted your application.
For cheque, it will be mailed to your mailing address directly.
收集及使用個人資料聲明 Personal Information Collection Statement

• 書院根據香港個人資料（私隱）條例（“該條例”）的要求下，收集、持有、處理或使用你的個人資料。收集到的個人資料僅用於合法和相關的用途，書院會採取一切切實可行的步驟確保持有的個人資料準確無誤，以及保護個人資料，以避免未經授權或意外洩漏、刪除或作其他用途。
The College recognises its responsibilities in relation to the collection, holding, processing or use of personal data under the Personal Data (Privacy) Ordinance of Hong Kong (the Ordinance). Personal data will be collected only for lawful and relevant purposes and all practicable steps will be taken to ensure that personal data held by the College is accurate. The College will take all practicable steps to ensure security of the personal data and to avoid unauthorized or accidental access, erasure or other use.

• 你是自願提供你的個人資料。請注意，如果你未能提供所須的個人資料，書院可能無法處理你的申請。書院在此申請過程中收集到的個人資料，將用於與此申請直接相關的用途，包括但不限於處理申請、通知相關申請人等。你所有提供的個人資料將保密處理。
The provision of your personal data is voluntary. Please note that if you do not provide us with the required personal information, the College may not be able to process your application. Please note that personal information collected by the College during this application process would be used for purposes directly related to the application, including but not limited to processing applications, notifying relevant applicants, etc. All personal information provided would be kept confidential.

• 在該條例下，你有權向書院確認及要求書院通知你其持有你個人資料的類別，你亦有權向書院獲取資料副本及更正任何不正確的資料。你亦有權向書院提出終止處理及持有你的個人資料，或刪除相關的資料。
Under the Ordinance, you have the right to ascertain whether the College holds your personal data and request the College to inform you of the type of personal data held by it. You also have the right to obtain a copy of the data and to correct any data that is inaccurate. You may also request the College to terminate processing and handling your personal data, or to delete the relevant data.

• 肖像權使用聲明：書院有機會在活動期間進行拍攝、錄影或直播，所拍攝的照片或錄像將有機會用作記錄、推廣及宣傳用途。參加者同意在不需另行通知的情況下，授權予書院使用所得肖像。（參加者可於之後的任何時候電郵至 unitedcollege@cuhk.edu.hk，要求停止使用個人資料。）
Consent of Portrait Rights: The activity may be photographed, filmed and live-streamed. The participant agrees and consents to grant the College the absolute and irrevocable portrait right and permission to record, exhibit, display and publish the moving and/or still pictures and/or videotaped images of the participant without further notice. (Applicants can email unitedcollege@cuhk.edu.hk anytime to request for terminating the use of your personal data.)

本人已閱讀及同意以上聲明 I have read and agree to the above Terms

收集及使用個人資料聲明 Personal Information Collection Statement • 書院根據香港個人資料（私隱）條例（“該條例”）的要求下，收集、持有、處理或使用你的個人資料。收集到的個人資料僅用於合法和相關的用途，書院會採取一切切實可行的步驟確保持有的個人資料準確無誤，以及保護個人資料，以避免未經授權或意外洩漏、刪除或作其他用途。 The College recognises its responsibilities in relation to the collection, holding, processing or use of personal data under the Personal Data (Privacy) Ordinance of Hong Kong (the Ordinance). Personal data will be collected only for lawful and relevant purposes and all practicable steps will be taken to ensure that personal data held by the College is accurate. The College will take all practicable steps to ensure security of the personal data and to avoid unauthorized or accidental access, erasure or other use. • 你是自願提供你的個人資料。請注意，如果你未能提供所須的個人資料，書院可能無法處理你的申請。書院在此申請過程中收集到的個人資料，將用於與此申請直接相關的用途，包括但不限於處理申請、通知相關申請人等。你所有提供的個人資料將保密處理。 The provision of your personal data is voluntary. Please note that if you do not provide us with the required personal information, the College may not be able to process your application. Please note that personal information collected by the College during this application process would be used for purposes directly related to the application, including but not limited to processing applications, notifying relevant applicants, etc. All personal information provided would be kept confidential. • 在該條例下，你有權向書院確認及要求書院通知你其持有你個人資料的類別，你亦有權向書院獲取資料副本及更正任何不正確的資料。你亦有權向書院提出終止處理及持有你的個人資料，或刪除相關的資料。 Under the Ordinance, you have the right to ascertain whether the College holds your personal data and request the College to inform you of the type of personal data held by it. You also have the right to obtain a copy of the data and to correct any data that is inaccurate. You may also request the College to terminate processing and handling your personal data, or to delete the relevant data. • 肖像權使用聲明：書院有機會在活動期間進行拍攝、錄影或直播，所拍攝的照片或錄像將有機會用作記錄、推廣及宣傳用途。參加者同意在不需另行通知的情況下，授權予書院使用所得肖像。（參加者可於之後的任何時候電郵至 unitedcollege@cuhk.edu.hk，要求停止使用個人資料。） Consent of Portrait Rights: The activity may be photographed, filmed and live-streamed. The participant agrees and consents to grant the College the absolute and irrevocable portrait right and permission to record, exhibit, display and publish the moving and/or still pictures and/or videotaped images of the participant without further notice. (Applicants can email unitedcollege@cuhk.edu.hk anytime to request for terminating the use of your personal data.) 本人已閱讀及同意以上聲明 I have read and agree to the above Terms 同意 Agree
Enquiry 查詢: Ms Chillies Tam (3943-1948/chilliestam@cuhk.edu.hk) or Ms Kate Chau (3943-7582/katechau@cuhk.edu.hk) or Ms Ming Lee (3943-7598/minglee@cuhk.edu.hk)
Disclaimer The personal data collected will be used by United College (UC) and authorised personnel for processing the captioned purposes in accordance with relevant provisions of the Personal Data (Privacy) Ordinance.

【小組活動資助申請表】聯合書院岑才生學長計劃：2025-2026 何萬森學年【Group Activities Sponsorship Reimbursement Form】UC Shum Choi Sang Mentorship Programme: Year of Ho Man Sum 2025-2026

A. Personal Particulars

B. Payment Method

C. Expenditure Information

D. Mentor/Mentee's Sharing (Sharing will be posted on college website/social media)

E. Supporting Documents

F. Declaration

College Staff will contact you if there is any problem with your application. Otherwise, reimbursement will usually take 1-2 months to process.

Enquiry 查詢: Ms Chillies Tam (3943-1948/chilliestam@cuhk.edu.hk) or Ms Kate Chau (3943-7582/katechau@cuhk.edu.hk) or Ms Ming Lee (3943-7598/minglee@cuhk.edu.hk)