Queen's College Old Boys' Association

QUEEN'S COLLEGE OLD BOYS' ASSOCIATION TUNG LO WAN ROAD, TAI HANG, HONG KONG TEL : 25772066 FAX : 25763113

Membership Application Form

 Life Member  Ordinary Member  Preparatory Member

I ______would like to apply for the above membership of the Queen's College Old Boys' Association (“the Association”) and hereby attach *cash / cheque number ( ) as my subscription fee.

My application is being recommended by ______( ) ( If Any )

Section I (for Publication in the Membership Directory) Name in English: ______Name in Chinese: ______

 Student From year ____/____ (at Form __ ) to year ___/___ (at Form __ ) House ______

 Teaching staff From year ____/____ to year ____/____ Company: Position: ______E-mail address: Section II (for the Association’s Records Only) Home Address: Home Phone No.: _Mobile Phone No: Office Address: Office Phone No: Office Fax No.:

Qualification:

Job Classification:

I hereby declare that I shall abide by the Constitution and any rules of the Association. I * agree/disagree to publish and/or disclose the information contained in Section I above in the QCOBA Directory.

______Signature of Applicant Date

* Delete whichever is inapplicable

(Revised - 3/2014) To be completed by the Association

Application received on ______

Application  accepted  not accepted

Membership type  Life  Ordinary  Preparatory

Membership No. ______

______Signature of Manager Date

Categories of membership

Life Membership and Ordinary Membership shall be open to – (i) any Old Boy; and (ii) any past and present member of the teaching staff of the Queen’s College.

Preparatory Membership shall be open to any present student of the Queen’s College.

Subscription fee

( a ) Life Membership : HK$1,000; or HK$500 in the case of an application from an Old Boy made within one year from the date he has ceased to be a student of Queen’s College. For the avoidance of doubt, the fee payable hereunder is not refundable in any event either in whole or in part once it is paid and a life membership is issued.

( b ) Ordinary Membership : HK$100 for a relevant year

( c ) Preparatory Membership : HK$50 for the relevant period

(Revised - 3/2014)