免費訂閱上環文娛中心節目資料
Free Subscription of Programme Information of 
Sheung Wan Civic Centre

請在適當位置加「」 Please put a “  ” in an appropriate box

	申請以電子郵件形式免費訂閱上環文娛中心網上版每月節目表
Apply for free subscription of Online Sheung Wan Civic Centre Monthly Event Calendar by e-mail

	更改個人資料或更新電郵地址
Update the personal particulars or change e-mail address

	取消免費訂閱服務
Unsubscribe the programme information

請填妥下列表格寄回香港皇后大道中345號上環市政大廈5樓上環文娛中心或傳真至2851 1075或電郵至pvohkw@lcsd.gov.hk。(查詢電話：2853 0729)
Please complete the form below and send to Sheung Wan Civic Centre, 5/F, Sheung Wan Municipal Services Building, 345 Queen’s Road Central, Hong Kong, or fax to 2851 1075, or e-mail to pvohkw@lcsd.gov.hk .
(Enquiries: 2853 0729)

姓名 :
Name																							
	英文English (姓氏在前Surname first)
		
					  *先生/太太/女士/小姐 Mr./Mrs./Ms./Miss	
	中文Chinese		
			
聯絡電話 :
Contact Tel. No.										

電郵 :																											
Email Address		
*請刪去不適用者  Please delete as appropriate                        Ref. No. __________________(for office use only)

個人資料(私隱)收集聲明
1.	你所提供的資料將會用作分發上環文娛中心的節目資料或其他市場推廣的用途。
2.	康樂及文化事務署可能會將部份資料給予其他政府部門以作市場推廣用途。
3.	除個人資料(私隱)條例所訂明的豁免外，根據同一條例第18及22條及附表1第6項原則，你有權要求查閱及更改本表格內所載的個人資料。
4.	如欲更改或查詢個人資料，請致函副經理(港島西)市場推廣及地區活動，其電郵地址載於本表格上。

Notification of Personal Data Collection
1.	The information provided by you will be used for sending of programme information of Sheung Wan Civic Centre and for other marketing purposes.
2.	The Leisure and Cultural Services Department may disclose some of your information to other government departments for marketing purposes.
3.	Subject to exemptions under the Personal Data (Privacy) Ordinance, and in accordance with Section 18 and 22 and Principle 6 of Schedule 1 to the Ordinance, you have a right of access and correction of the personal data provided in this form.
4.	Request for personal data access and correction should be sent to Assistant Manager (HK West) Marketing & District Activities, whose e-mail address is printed on this form.