(To be completed in block letters 请用英文正楷填写)
PERSONAL DATA ---------- 个人资
HONG KONG POLICE 香港警务处 APPLICATION FOR JOINING AS "JUNIOR POLICE CALL MEMBER" 『少警讯会员』加表格 PART A 甲部 PERSONAL DETAILS 个人资
I wish to be a JPC member. The details you require are as follows: 本人欲申请为『少警讯』会员,现填报以下简:
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NAME 姓名(中文) C.C. Code 中文姓名电码 DATE OF BIRTH 出生日期 DD HOME ADDRESS 住址 / MM / YY
(英文) PLACE OF BIRTH 出生地点 HKID OR BIRTH CERT.NO. 香港身份证/出生证明书号码
SEX 性别
TEL. NO. 电话 E-MAIL ADDRESS 电邮地址 NAME OF SCHOOL 就学校名称
EDUCATION LEVEL 教育程 NATIONALITY 国藉 POLICE OFFICER □ NO 否 □ YES 是 UI 警察编号 DATE 日期
OCCUPATION 职业 COUNTRY OF ORIGIN 原籍
SIGNATURE OF APPLICANT 申请人签署
PART B 乙部 CONSENT FORM 同意书
I hereby authorise the Commissioner of Police, or his representative, to release full particulars of any and all criminal convictions recorded against me to Police Public Relations Branch. 本人现授权警务处处长,或其代表,向警察公共关系科发放任何及全部有关本人刑事判罪纪 的所有资.
Signature of Guardian/Parent Signature of Applicant 申请人签名 Witnessed by 证人签名 Date 日期
*To be completed by applicant aged below 18 只适用於十八岁以下之申请人 *The collected personal data is solely used for activities of Junior Police Call. Should you wish access to your personal data, you may approach Chief Inspector (Support) of Police Public Relations Branch. 所收集的个人资,只供少警讯之用.如要求查阅或改正个人资,请向警察公共关系科总督察 (支援) 提出.
*
Official use only 本必填写 POLICE DISTRICT JPC MEMBERSHIP NO.