新亞書院YIA儲物箱申請表/ Application for YIA Locker of New Asia College

儲物箱按金 Locker Deposit: $100 (全年 per academic year)
扣款銀行帳戶 Debited Bank Account: 293-005005-018

申請儲物箱同學注意事項：
1. 儲物箱只供新亞書院走讀同學使用；
2. 儲物箱如有損壞，同學需負責維修費用；
3. 儲物箱使用期於畢業時屆滿，同學必須於七月底前(畢業年份)交回儲物箱及領回按金，逾期辦理者，書院有權處理箱內物件及沒收按金。

Important Notes for YIA Locker Applicants:
1. Lockers are available exclusively to non-residential students of New Asia College.
2. Students are responsible for any repair costs incurred due to damage to the locker.
3. The locker rental period ends upon graduation. Students must return the locker and claim their deposit by the end of July in their graduation year. Late returns may result in forfeiture of both locker contents and deposit, without appeal.

中文姓名 Chinese Name
英文姓名 English Name
學系/年級 Dept/Year：
學號 SID Number:
聯絡電話 Contact Number:
Must be a number less than or equal to 8.
電郵地址 Email:
按金繳交證明 Proof of Deposit Receipt:

Attach Files
簽名 Signature：

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Disclaimer The personal data collected will be used by New Asia College (NA) and authorised personnel for processing the captioned purposes in accordance with relevant provisions of the Personal Data (Privacy) Ordinance.