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Serial No


									                                                                                                                       Rev (Jan 2010)
Serial No.

Application for Use of Facilities in Community Hall / Community Centre (CH/CC) in Tuen Mun

Section A

     Name of CH/CC

1.   Applicant


                Applicant No. (       )    Please fill in the applicant number provided by the Tuen Mun District Office (TMDO)
                                           (Please submit the certificate of registration of a society if you have not received the
                                           applicant number from us.)


                                                                     Tel. No.

2.   Date of function                                      Time: From                         am/pm to                       am/pm

3.   Description of activity to be held:

     Name of function


     Target of service:                                             Estimated No. of participants:#

     # In each session, the minimum number of participants for using the multi-purpose hall is 10 whilst that for using the
       conference room or activity room is 5.

     Admission charges: ~ Yes                     No
                                                                          If yes, please state the amount chargeable per head.

     Application for exemption from payment of charges for using the facilities: Yes/No*
     (Please submit the balance sheet if admission charge is collected and you want to apply for exemption of payment.)

4.   Activities sponsored by Tuen Mun District Council

     ^ I *wish/do not wish to apply for priority booking of facilities (applicable to any proposed activity which has obtained
     sponsorship from Tuen Mun District Council or proposed activity for which sponsorship has been applied for).
         The proposed activity has obtained the sponsorship from Tuen Mun District Council. A copy of a confirmation letter
         from the Tuen Mun District Council is attached herewith.

         Application for Tuen Mun District Council‟s sponsorship in respect of the proposed activity has been made. I will
         submit a copy of a confirmation letter to Tuen Mun District Office as proof once it is issued by the Tuen Mun District
         Council (Should the applicant fail to submit a copy of a confirmation letter issued from the Tuen Mun District Council
         7 working days before the activity is held, the booking application will lapse automatically).

     ^ Applicable to one-off activity to be held at CHs/CCs in Tuen Mun after 6pm on Saturdays, or during Sundays and public
       holidays (except the first three days of the Lunar New Year).

     Please indicate with a “”

                                                                                                                         Page 1 of 2
                                                                                                                       Rev (Jan 2010)
5.   Facilities applied for (For use of furniture and equipment, please also specify type and quantity.)

                               Venue                             Air-Conditioning              Other facilities, please specify


       Dressing Rooms (Male/Female)*

       Conference Room

       Activity Room/Classroom/Meeting Room*

       Badminton Court

       Covered Playground

      Others (Please specify                            )

     Please note that chairs are provided in the hall. Applicants are requested to provide public address system and their own
     technician to operate the lighting panel if necessary, and to arrange for seating.

6.   I hereby declare that I have read and agreed to observe the conditions for use of the above facilities as set out in the „Rates
     of Charges and Exemption from Payment of Charges for Use of Community Halls / Community Centres‟ and „Guidelines
     on the Use of Facilities in Community Halls / Community Centres in Tuen Mun‟.

     Official stamp of applicant                                        Signature :
     (applicable to applicant
     organization only)
                                                                        Name        :

                                                                        Position    :

                                                                        Date        :

     Information provided in this form will be used for assessment of application, notification of results, calculation of
     utilisation rates, collection of fees (if any) and record keeping purposes.

     * Delete as appropriate

     此表格的中文版本可於 下載

                                                                                                                         Page 2 of 2
                        Statement of Income and Expenditure of Paid Activity
Name of activity
活動名稱:                       :
Date / Time of activity :
活動日期 / 時間

              Income 收入                             Expenditure 支出             Remarks 備註
           Item 項目        Amount 款項                Item 項目         Amount 款項

           Total 總數:                               Total 總數:

Balance : Surplus / Overdraft / Break-even*
            活動結存:*盈餘 / 透支 / 收支平衡 $

Other remarks :

I hereby certify that the above information is true and correct.

                                                    Signature 簽署 :
                                                       Name 姓名 :
                                                         Post 職位 :
Official stamp of organization              Name of organization :
(applicable to applicant organization only)           機構名稱

                                                         Date 日期 :
* Delete as appropriate 請刪去不適用者

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