MEMBERSHIP APPLICATION FORM

I would like to join the Hong Kong Human Rights Monitor.
I enclose my joining fee on HK$ 100/ a donation of _____________.

NAME _____________________________________________________

POSTAL ADDRESS _________________________________________

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EMAIL ____________________________________________________

TEL & PAGER _______________________________________ (Office)

_______________________________________ (Home)

FAX                      _______________________________________ (Office)

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OCCUPATION ______________________________________________

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PARTICULAR AREAS OF INTEREST

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SIGNATURE________________________________________________

DATE ______________________________________________________

PLEASE RETURN THIS FORM TO US BY POST
(Address: 4/F Kam Tak Building, 20 Mercer Street, Sheung Wan, Hong Kong)
WITH YOUR CHEQUE (Make cheque payable to HONG KONG HUMAN RIGHTS MONITOR)

Informations Collected are for Monitor's Internal Use Only.