<p> Office for Film, Newspaper and Article Administration (“OFNAA”) “Control of Obscene and Indecent Articles Ordinance” Related Publicity and Public Education Activities Subsidising Scheme 2018-2019 Application Form Note : (1) Please read the details of the Scheme (http://www.ofnaa.gov.hk/eng/publicity/COIAOScheme.htm) and attend the briefing on 6 February or 7 March 2018 before submitting an application. (2) One application form should be completed in respect of one activity. (3) Applications should be mailed to Miss Claudia LEE, Project Officer, OFNAA , 39/F, Revenue Tower, 5 Gloucester Road, Wanchai, Hong Kong on or before 29 March 2018. Late applications will not be accepted. (4) Please tick in the appropriate box. (5) Please delete as appropriate for *. (6) For enquiries, please contact Miss Claudia LEE at 2594 5921. (7) Personal particulars submitted by the applicants will only be used for purposes pertaining to the application.</p><p>Part A Applying Organisation </p><p>Name of (Chinese) Telephone: Organisation : (English) Fax : </p><p>Address : (Chinese) (English)</p><p>Type of organisation: (Please attach a copy of identification document, e.g. registration document or letters issued by the Inland Revenue Department or other government departments.)</p><p>school  registered charitable institutions  non-profit-making organisations</p><p>Form of establishment:  registered under the Education Ordinance  registered under the Societies Ordinance  registered under the Companies Ordinance  other (please specify) </p><p>Sources of funding: Social Welfare Department Community Chest Education Bureau Revenues from properties/services Membership fees, $ each month /year* Contributions from members /students/followers* Others (please specify) </p><p>Objective of services and target: </p><p>Name of person-in-charge: (Chinese) (English) Post: Daytime contact no.: Mobile no.: Fax: e-mail address: Record of previous subsidy from OFNAA</p><p> Has not applied for OFNAA’s subsidy previously  Has applied for OFNAA’s subsidy before but the application was not successful  Had received OFNAA’s subsidy before but no application was made in 2017-18  Has received subsidies in the past 12 months Please list out the programmes subsidised by OFNAA in the past: (Please write on a white paper, the following must be included)</p><p>Name of programme Date Amount of subsidy Remarks (Please give a brief account of the effectiveness of the programme)</p><p>Please provide details below if you have applied for subsidies from other organisations for this project: Organisation providing subsidy: Name of subsidising scheme: Applied amount: Approved amount: / □ Application under consideration (if appropriate) Part B</p><p>Activity Proposal</p><p>(a) Name of activity: (note: the name should reflect the objective and nature of the activity clearly)</p><p>(b) Objective(s) and nature of the activity: </p><p>(i) Objective(s) of the activity:  (1) To promote awareness of the “Control of Obscene and Indecent Articles Ordinance” amongst children, youngsters and the community;  (2) To draw the attention of parents, teachers, social workers and other members of the public to the negative impact of objectionable materials that may have on children and youngsters;  (3) To help youngsters to develop independent thinking, better analytical abilities, positive values and a positive outlook on life with a view to helping them to build up stronger resistance to the possible negative consequences of objectionable materials.  (4) Others (please specify) ______</p><p>(May choose more than one item from the above but must include item (1) or (2))</p><p>(ii) Nature of the activity: </p><p>(c) Major targets and the community to be served (if applicable):</p><p>(d) Particulars of the activity: Please set out the following information on a separate sheet and e-mail a softcopy to [email protected] : i Details on how the activity design can achieve the “Objective(s) of the activity” under item (b) ii Outline and timetable iii Information on 1) Detailed contents / format 2) promotional strategy 3) implementation date(s) and venue(s) 4) target and number of participants 5) number of volunteers and frequency of attendance 6) contingency plan 7) evaluation of activity iv Applicant’s experience in organising similar activities and the results v Estimated revenue and expenditure </p><p>1) publicity materials 2) rental of venue 3) rental of camp 4) transportation 5) meal/refreshment 6) stationery 7) Fees for instructors 8) miscellaneous and photography 9) licences, copyright and insurance etc 10) audit</p><p>Sources of income</p><p>1) fees from participants 2) cost and items to be borne by the applicant</p><p> vi Total expenditure vii Proposed amount of subsidy from OFNAA viii If the budget includes tutor fee, please state clearly: (a) Breakdown of sessions and hours involved. For example: Tutor fee: (1) $_____ (hourly rate) x (Each session) _____ hours x (Each group) _____ sessions x _____ groups (2) $_____ (daily rate) x (Each group) _____ days x _____ groups (_____ hours per day) (b) Please provide justifications and qualifications of proposed tutor if professional tutor fee is applied. For details, please refer to the “Subsidy of Expenditure Items”.</p><p>Part C (1) Declaration:</p><p>I apply for subsidy under the “Control of Obscene and Indecent Articles Ordinance” Related Publicity and Public Education Activities Subsidising Scheme 2018-19 on behalf of______(name of organisation). I hereby certify that the particulars given above are true and correct. If the application is approved, I undertake:</p><p> a) to enter into an agreement with OFNAA in respect of the activity; b) to conduct and complete the activity on or before 31 March 2019 and submit the activity, financial and audit reports on time; c) to refund in full any advances of subsidy to OFNAA if we withdraw from the Scheme in the course of implementing the activity without reasonable grounds ; d) to bear all expenditures incurred in conducting the activity before this application is approved by OFNAA; and e) not to change the contents of the activity without written consent from OFNAA.</p><p>(2) Authorised Person in charge of the Scheme:</p><p>I authorise the following person to be in charge of the activity:</p><p>Name of person in charge of the activity: (Chinese) (English)</p><p>Post Title: </p><p>Daytime contact no: Mobile no: Fax: </p><p>E-mail address : </p><p>(3) Registration / Identification Documents</p><p>I herein attach the following identification documents for assessment:</p><p> a) </p><p> b) c) </p><p>Stamp of Organisation Signature: </p><p>Name of Organisation Representative: </p><p>Name of Organisation: </p><p>Post Title: </p><p>Date: </p><p>N ote on collection of Personal Data</p><p>1. Personal particulars submitted by the applicants will only be used for the purpose pertaining to the application. 2. In accordance with Section 18, 22 and Principle 6 of Schedule 1 to the Personal Data (Privacy) Ordinance, the applicants have the right to request access to and to request the correction of personal data as stated in this form </p><p></p><p>End Specimen (For reference only)</p><p>Budget for the Activity</p><p>Please provide a breakdown of the estimated expenditure and revenue in accordance with item (d)(v) of Part B. </p><p>Estimated Expenditure of the Activity</p><p>Expenditure Item Unit Cost Quantity Total Cost Subsidy applied Subsidy Amount (to be completed by OFNAA) Publicity a) Posters $5/ piece 1000 pieces $5,000 $5,000 b) Printing of leaflets $1.5/ piece 3000 pieces $4,500 $4,500 Workshops a)Photocopying of $0.5/piece 20 pieces x 60 $600 $600 handouts persons x $0.5 b)Stationery According to 60 sets $1,200 $1,200 quoted price c) Refreshment $20/person 60 persons x $20 $1,200 $1,200 Exhibition cum Carnival a) Venue rental $3,000 1day $3,000 $0 (paid by the organisation) b) Stage design and $5,000 1day $5,000 $5,000 rental c) Exhibition boards -- 8 pieces -- -- (provided by and materials OFNAA) d) Public $30/ person 20 $600 $600 transportation expenses for volunteers e) Prizes for game -- 500 -- -- (provided by booths OFNAA) f) Hiring mini-van $570 2 trips $1,140 $1,140 Auditor’s fee N.A. (Applicable for activity with a subsidy of $20,000 or above) Total: $22,240 $19,240</p><p>Estimated Revenue of the Activity</p><p>Item Amount ($) a) Cost to be borne by the organisation $3,000 b) Fees from participants ($10 x 60 persons) $600 c) Others $0 Total: $3,600</p><p>Total amount of subsidy applied from OFNAA after deduction of all revenues: Estimated expenditure of the activity: $22,240 Estimated revenue of the activity: $3,600 Subsidy applied for: $18,640 </p>