餐飲會員號碼：

Dining Membership
香港渣甸山居民協會 Number. : D
Jardine's Lookout Residents' Association
香港渣甸山祈禮士道二號地下
No.2 Creasy Road Jardine's Lookout Hong Kong
Tel: 2890 7735 Fax: 2577 0047 E-mail: jlra_membership@yahoo.com.hk

餐飲會員証申請表
Dining Membership (Class A) Application Form

先生 / 夫人 / 女士 / 其他: 英文姓名: 中文姓名:

Mr / Mrs / Ms / Others English Name Chinese Name
生日日期: 身份証號碼: 國藉:
Date of Birth: HK I.D. Nationality
住 址： 住址電話:
Resident Address Resident Telephone
公司地址: 公司電話:
Company Address Company Telephone
職 業:: 電郵地址: 手提:
Occupation E-mail Mobile
申請人簽名: 簽發日期:
Applicant's Signature Issued Date
條款及細則 Terms & Conditions
1. 餐飲會員入會費港幣6,000元正。（現金或支票抬頭寫：香港渣甸山居民協會）
Dining Membership fee $6,000. (Cash or Cheque payable to : Jardine's Lookout Residents' Association)
2. 每年會費$1,200 ,會籍不能轉讓。
Annual Subscription Fee $1,200 and membership is non-transferable.
3. 此餐飲會員証只准許持有人與其親友享用於本會之西餐廳及中菜廳。
The Dining Membership is for member and member's guest usage at Cafe & Wine Cellar and Chinese Restaurant only.
4. 餐飲會員須隨時展示會員咭。
Please present your membership card upon request.
5. 有關於會籍事宜請致電2890 7735或親臨香港渣甸山居民協會。
For further information, please enquire our main office or contact us by phone on 2890 7735.
6. 本會可保留一切權力,會員不得作爭議,同時亦有權在任何情況下取消該會員會籍而會費概不退還。
JLRA reserves the right to make final decision on any disputes and authority to cancel membership. All fees are non-refundable.
7. 申請者需經本會委員會審批。
This application is subject to the approval of the“COMMITTEE”.
8. 會員權利及特權需受到“本會的章程”規定，隨時會作出修改。
Membership rights & privileges are subject to the provisions of “THE ASSOCIATION'S BY-LAWS” which may be amended
from time to time.

本會專用：FOR OFFICE USE ONLY

Introduced by ___________________

Chairman of
Committee Member :
Dining Membership :
( Name ) ( Name )

( Signature ) ( Signature )

Application Form (Class A) by JLRA100105 (e-mail) (1)%5B1%5D.xls