□ Member □ Non-member Member number：_________________________________
Name:________________________________________________
Sex:□ Male □ Female
Tel (Home):____________________________________________
Tel (Office):_______________________________ Mobile/Pager:________________________________
Fax:_________________________________ E-mail：__________________________________________
Address:____________________________________________________________________________________
Rental Fee for farm plot:
HK$900 /season(3 months)/100sq. ft.plot
( 25% off if paying for 1 year’s fee in advance)
( 10% off for member )
I would like to rent the farm plot(s) from Green Peng Chau Association as below:
No. of season(s) ______ , No. of plot(s) *______, □ member □ non-member □ pay for 1 year’s fee in advance
Total amount: HK$________________
* one plot = 100 sq ft
□ Total Amount HK$________________By Cheque (Bank:_______________________Cheque Number:________________)
Make a crossed cheque payable to Green Peng Chau Association
□ Total Amount HK$________________By Cash or By Transfer
Deposit direct to Hong Kong Bank A/C # 117-030783-001. Kindly attach copy of the pay-in slip and return with this application.
Signature:_____________________________________ Date:_____________________________________
We comply with the requirements of the Personal Data (Privacy) Ordinance in Hong Kong to protect your personal data
Official use only
Date:_____________________________________
Expiry Date:_____________________________________
Farm Plot No.:___________________________________
Remarks:______________________________________
Handled by:______________________________________