網上留座申請
Online Request for Reservation
日期 Date :

2011 年8 月31 日（星期三）
31 August 2011 (Wednesday)
時間 Time :

晚上 7 至 9 時
7:00pm – 9:00pm
地點 Venue :

香港跑馬地黃泥涌道133 號禮頓山社區會堂
Leighton Hill Community Hall, 133 Wong Nai Chung Road, Happy Valley, Hong Kong

請填上出席者的姓名及聯絡資料，最多可填寫兩人的資料，並輸入驗證碼，然後提交申請。我們會在收到你遞交的表格後盡快聯絡你，以確認你的留座申請。謝謝。
Please provide attendants' details for a maximum of two entries and submit your request after entering the verification code. Upon receipt your submission of request, we will contact you as soon as possible to confirm your reservation. Thank you.

出席者姓名 Name of attendant :
聯絡電郵 Email Address :
聯絡電話 Telephone Number
:

出席者姓名 Name of attendant :
聯絡電郵 Email Address :
聯絡電話 Telephone Number
:

公聽會以粵語進行。若有需要，公聽會可提供英語即時傳譯服務。你是否需要此項服務？
The public hearing will be conducted in Cantonese. English simultaneous interpretation service may be provided upon request. Do you need English simultaneous interpretation service?

是 Yes
公聽會亦會提供手語服務。
Sign language service will also be provided at the public hearing.
驗證碼 Verification Code    
請輸入驗證碼 Please enter the characters in the image.
 verification image
如驗證碼不清晰，請按圖像重新載入。
If the characters are not clear, please click the image to reload.

你所提供的資料，只作留座申請及聯絡用途。
Submitted information will only be used for reservation and contact purpose.