Membership Card Replacement Exercise

1

Verification

Membership Card Replacement Exercise

* Mandatory fields

UI No. / Membership No.:

HKID No. (prefix and first four digits) :

Prefix

Digits

English Surname:

Verification Code:

2

Personal Information Collection Statement

Purpose of Collection

The personal data provided in the application will be used by the Hong Kong Police Force for one or more of the following purposes:-
(a) to process membership application;
(b) to process application for membership renewal;
(c) to process declaration of lost membership card;
(d) to process carpark label;
(e) to process application for activities;
(f) to process enrolment of recreational courses and activities;
(g) for communication with members;
(h) for any other legitimate purposes as may be required, authorised or permitted by law.
The provision of personal data is voluntary. If you do not provide sufficient information, the Club may not be able to process your application.

Classes of Transferees

The personal data you provided are mainly for use within the Hong Kong Police Force and may be disclosed to other units within the organisation for the purposes mentioned in paragraphs 1 and 2 above, if required. You also authorise POC/PSRC Management to collect your personal data from other units within the Hong Kong Police Force for the above-mentioned purposes.

Access to Personal Data

You have the right to request access to and correction of your personal data as provided for in sections 18 and 22 and Principle 6 of Schedule 1 of the Personal Data (Privacy) Ordinance (Chapter 486).

Enquiries

Enquiries concerning the personal data collected by means of this application, including the request for access and correction, should be addressed to Manager of POC or Manager of PSRC.

I have read and agreed the above Personal Information Collection Statement and terms.

3

Select a Club

* Mandatory fields

Select Club

POC

PSRC

Select Your Status

4

Principal Member

Application Information

* Mandatory fields

Personal Particulars (Principal Member)

Existing Membership Number

English Surname

English Given Name

Chinese Surname

Chinese Given Name

Title

Gender

HKID No.

Date of Birth

Age:

Year(s)

Month(s)

Marital Status

UI Number

Rank

Date of Joining the Force

Contact Information

Mobile Phone Number

Office Telephone Number

Residential Telephone Number

Email Address

Confirm Email Address

Emergency Contact

Name

Relationship

Telephone Number

Photo

Please upload a recent colour photo

Application for Membership Card Replacement (Family Member)

Spouse

Children

5

Personal Particulars (Spouse)

* Mandatory fields

Personal Particulars of Spouse

Existing Membership No.

English Surname

English Given Name

Chinese Surname

Chinese Given Name

Title

Gender

Information of Identity Document

HKID No.

Other ID/ Passport No.

Date of Birth

Age:

Year(s)

Month(s)

Marital Status

Mobile Phone Number

Email Address

Confirm Email Address

Photo

Please upload a recent colour photo

6

Personal Particulars (Child)

7

Carpark Label

Are you holding a valid carpark label of our Club?

Yes

No

Particulars of Carpark Label

* Mandatory fields

Vehicle Registration Mark

Vehicle Class

Details of Registered Owner

Full Name of Registered Owner

Current Carpark Label Expiry Month & Year

Particulars of Carpark Label

* Mandatory fields

Vehicle Registration Mark

Vehicle Class

Details of Registered Owner

Full Name of Registered Owner

Current Carpark Label Expiry Month & Year

8

Preview

9

Terms and Conditions

Please read the below terms and conditions:

I understand that, if my membership application is approved I and my family members must comply with the rules and by-laws of the Club and regulations progmulgated by the Management. I also understand that non-compliance with the Club rules and by-laws may result in termination of my membership and forfeiture of my right to use the Club facilities.

I understand that I shall complete the application within three months. If I do not collect my membership card within one year after submission of application, the Club reserves the right to destroy all relevant membership card(s) and application information without prior notice.

I confirm that all information given above is true and correct. I understand that if I make a declaration which I known to be false or do not belive to be true, I may be liable to any disciplinary actions and suspension of my membership.

I agree to return all membership cards that are invalid due to termination of service or for any other reason.

I give my consent to the Hong Kong Police Force or the Club to send the information of welfare matters to my email address.

If you agree the above terms and conditions, please tick the boxes.

10

Application Submission

The application of membership has been submitted, below are your application details.

Your Application Date:
Application Number:

Personal Particulars (Principal Member)
Existing Membership Number:
English Surname:
English Given Name:
Chinese Surname:
Chinese Given Name:
Title:
Gender:
HKID Number:
Date of Birth:
UI Number:
Rank:
Date of Joining the Force:
Membership Related Information
MPS Point:
Selected Retirement Scheme Age:
Date of Struck-Off-Strength(SOS):
Spouse Membership No.
Contact Information
Mobile Number:
Office Telephone Number:
Residential Telephone Number:
Email Address:
Emergency Contact
Name:
Relationship:
Telephone Number:
Photo

Other Supporting Document

Usage of Fitness Room
Usage of Fitness Room:

New Membership Card Pick-up Location

Personal Particulars (Spouse)
Existing Membership Number:
English Surname:
English Given Name:
Chinese Surname:
Chinese Given Name:
Title:
Gender:
HKID Number:
Other ID No.
Date of Birth:
Mobile Number:
Email Address:
Photo:

Marriage Certificate

Other Supporting Document

Usage of Fitness Room
Usage of Fitness Room:

Personal Particulars (Child) 1
Existing Membership Number:
English Surname:
English Given Name:
Chinese Surname:
Chinese Given Name:
Title:
Gender:
HKID Number:
Other ID No.
Date of Birth:
Marital Status:
Mobile Number:
Email Address:
Photo:

Birth Certificate

Other Supporting Document

Usage of Fitness Room
Usage of Fitness Room:

Personal Particulars (Child) 2
Existing Membership Number:
English Surname:
English Given Name:
Chinese Surname:
Chinese Given Name:
Title:
Gender:
HKID Number:
Other ID No.
Date of Birth:
Marital Status:
Mobile Number:
Email Address:
Photo:

Birth Certificate

Other Supporting Document

Usage of Fitness Room
Usage of Fitness Room:

Personal Particulars (Child) 3
Existing Membership Number:
English Surname:
English Given Name:
Chinese Surname:
Chinese Given Name:
Title:
Gender:
HKID Number:
Other ID No.
Date of Birth:
Marital Status:
Mobile Number:
Email Address:
Photo:

Birth Certificate

Other Supporting Document

Usage of Fitness Room
Usage of Fitness Room:

Personal Particulars (Child) 4
Existing Membership Number:
English Surname:
English Given Name:
Chinese Surname:
Chinese Given Name:
Title:
Gender:
HKID Number:
Other ID No.
Date of Birth:
Marital Status:
Mobile Number:
Email Address:
Photo:

Birth Certificate

Other Supporting Document

Usage of Fitness Room
Usage of Fitness Room:

Personal Particulars (Child) 5
Existing Membership Number:
English Surname:
English Given Name:
Chinese Surname:
Chinese Given Name:
Title:
Gender:
HKID Number:
Other ID No.
Date of Birth:
Marital Status:
Mobile Number:
Email Address:
Photo:

Birth Certificate

Other Supporting Document

Usage of Fitness Room
Usage of Fitness Room:

Personal Particulars (Child) 6
Existing Membership Number:
English Surname:
English Given Name:
Chinese Surname:
Chinese Given Name:
Title:
Gender:
HKID Number:
Other ID No.
Date of Birth:
Marital Status:
Mobile Number:
Email Address:
Photo:

Birth Certificate

Other Supporting Document

Usage of Fitness Room
Usage of Fitness Room:

Personal Particulars (Child) 7
Existing Membership Number:
English Surname:
English Given Name:
Chinese Surname:
Chinese Given Name:
Title:
Gender:
HKID Number:
Other ID No.
Date of Birth:
Marital Status:
Mobile Number:
Email Address:
Photo:

Birth Certificate

Other Supporting Document

Usage of Fitness Room
Usage of Fitness Room:

Personal Particulars (Child) 8
Existing Membership Number:
English Surname:
English Given Name:
Chinese Surname:
Chinese Given Name:
Title:
Gender:
HKID Number:
Other ID No.
Date of Birth:
Marital Status:
Mobile Number:
Email Address:
Photo:

Birth Certificate

Other Supporting Document

Usage of Fitness Room
Usage of Fitness Room:

Personal Particulars (Child) 9
Existing Membership Number:
English Surname:
English Given Name:
Chinese Surname:
Chinese Given Name:
Title:
Gender:
HKID Number:
Other ID No.
Date of Birth:
Marital Status:
Mobile Number:
Email Address:
Photo:

Birth Certificate

Other Supporting Document

Usage of Fitness Room
Usage of Fitness Room:

Particulars of Carpark Label 1
Vehicle Registration Mark:
Vehicle Class:
Full Name of Registered Owner:
Details of Registered Owner:
Current Carpark Label Expiry Month & Year:
Other Supporting Document

Particulars of Carpark Label 2
Vehicle Registration Mark:
Vehicle Class:
Full Name of Registered Owner:
Details of Registered Owner:
Current Carpark Label Expiry Month & Year:
Other Supporting Document