Name Visitor Information 訪客資料 Visitors without a valid University card are required to complete this form two working days before the visit. Visitors will be notified upon confirmation. Enquiries: 2358-6710 訪客如無有效大學身份證明文件，請於參觀前兩個工作天，填妥下列資料作登記之用。登記後，訪客將收到確認通知。查詢: 2358-6710 Please make sure that the name of the visitor provided is the same as shown on the identification document. 請確保提供的訪客姓名與身份證明文件上的姓名相同。 Surname 姓 * Other Names 名 * Mobile Phone * Email Address * Visiting Date 參觀日期 * From 由 * AM 上午 PM 下午 To 至 * AM 上午 PM 下午 Car Plate Number, if driving: 如經私家車進入校園，請提供車牌號碼 Purpose of Visit 探訪目的 * Health Declaration 健康申報 Do the visitors have any of the following symptoms: fever, chills, cough, diarrhea, muscle pain, runny nose, shortness of breath? 訪客是否有以下症狀：發燒、發冷、咳嗽、腹瀉、肌肉疼痛、流鼻水、氣促？ Symptoms? YES 是 NO 否 Have the visitors been in contact with a confirmed case or preliminarily tested positive case of COVID-19 in the past 7 days? 訪客在過去 7 天內是否接觸過確診病例或初步檢測出為COVID-19 陽性病例？ In Contact? YES 是 NO 否 Are the visitors currently under a Government order to take a COVID-19 test and have not yet received a result? 訪客是否曾應香港政府要求進行2019新型冠狀病毒檢測，並正等待檢測結果？ Awaiting result? YES 是 NO 否 Have the visitors met the Vaccine Pass requirements in LeaveHomeSafe App (e.g. received a booster dose or hold a valid Provisional Vaccine Pass/medical exemption certificate and obtained a negative test report (conducted within last 14 days) /recovery record)? 訪客的「安心出行」流動應用程式是否載有符合政府要求的有效「疫苗通行證」？ （如：完成接種第三劑疫苗、持有「臨時疫苗通行證」或新冠疫苗接種醫學豁免證明書及過去14天內檢測陰性證明或有效「康復紀錄二維碼」等） Vaccine? YES 是 NO 否 The personal data provided in this form will be used for the handling of campus visitors only. Your personal data provided for this application will be kept for as long as necessary to fulfil the purpose of handling of campus visitors or a directly related purpose. Personal data which is no longer required will be destroyed. 備註：所收集的個人資料只會用作校園訪客進入許可申請。閣下的個人資料只會保存至完成處理校園訪客申請或相關程序為止。其後閣下的個人資料將會作廢並銷毀。 Go Back to page Top last modified 28 April 2022
