CKLC-暑-期-行-李-存-取-授-權-書.pdf
CKLC-暑-期-行-李-存-取-授-權-書.pdf
張崑崙書院 Cheong Kun Lun College 暑 期 行 李 存 取 授 權 書 Authorization form of Summer Luggage Storage or Retrieval AUTHORIZATION FORM For Summer Luggage Storage or Retrieval 代辦存/取暑期行李授權書 Luggage Storage 行李儲存 Luggage Retrieval 行李取回 I, the undersigned applicant, hereby authorize the following person to take care of, on my behalf, the storage or retrieval of summer luggage, according to the summer luggage storage or retrieval plan and instructions. 本人謹此授權下列人士按暑期行李存取方案及指示代辦及處理本人所有暑期行李之 事宜。 Applicant’s Details 申請人資料: Name in full (Please use BLOCK LETTERS) 姓名： UM Student Number 學生證編號： Email Address 電郵： Contact Number 聯絡電話： Authorized Person’s Details 被授權人資料： Name in full (Please use BLOCK LETTERS) UM Student Number 學生證編號： 姓名： Email Address 電郵： Contact Number 聯絡電話： Notices: 1. The applicant should submit the following documents to CKLC upon application. A completed authorization form signed by the applicant and authorized person; A copy of the applicant’s UM student card; A copy of the authorized person’s UM student card / identification document (with photo). 2. The applicant must inform the authorized person regarding the details of the to-be moved items before vacation or leaving the campus. 3. For better coordination and operation, it is highly recommended that the authorized person is an UM student. 4. UM will not be responsible for any damage to and / or loss of items belonging to the applicant caused whether by any act, omission, default or negligence of the authorized person. 1/2 Version001 張崑崙書院 Cheong Kun Lun College 暑 期 行 李 存 取 授 權 書 Authorization form of Summer Luggage Storage or Retrieval 5. The personal data collected in this form by CKLC will only be used for the summer luggage program and may also be transferred within UM and to entities that are in accordance with legal provision or with your prior consent, for the purpose of carrying out the related procedures. 6. For submission of application and enquiries, please contact CKLC general administration office at ext. 8822 9520. 注意事項 : 1. 申請人須於申請時遞交以下文件： 申請人及被授權人已填妥之本授權書； 申請人之澳大學生證影印本； 被授權人之澳大學生證或附有照片的身份識別文件影印本。 2. 申請人於休假或離開校園前必須告知被授權人所需處理物品詳情。 3. 建議被授權人為澳大學生，以便協調及運作。 4. 在行李存取過程中不論是否因為被授權人的任何作為、不作為、失責或疏忽而導致申請人 的 任何物品有所損壞或遺失，校方將不予負責。 5. 張崑崙書院辦公室將從本授權書所收集得到的個人資料，只用於行李寄存事宜。而這些個 人 資料亦可在澳大內部及其他依法律規定或獲閣下授權的實體之間傳遞，以便進行相關程 序 處理。 6. 如有垂詢及遞交申請，請聯繫張崑崙書院辦公室(8822 9520)。 I understood and accepted the above terms and conditions. 本人已明白並接受上述條款： Signature of Applicant 申請人簽名 Signature of Authorized Person 被授權人簽名 Date 日期 Acknowledgement 確認知悉: CKLC General Office 張崑崙書院辦公室 Date 日期 2/2 Version001