Whoops! There was a problem loading more pages. Retrying... Sponsorship Application Form_HKARM version 2017.pdf. Sponsor
Hong Kong Association of Rehabilitation Medicine (Hong Kong, China)
香港康 復醫學學會
Sponsorship Application Form Applicant’s Name: Surname
_________________(中文) First name
Organization: __________________________________
Sex:
M/F
Post: __________________________
Corresponding Address: _______________________________________________________________________________ _______________________________________________________________________________ E-mail Address: _________________________ Type of HKARM member:
Life member
Contact Telephone No.: __________________ Full member
Associate member
Name of Meeting: _______________________________________________________________ Date of meeting: ___________________________
Place: _____________________________
Participation in the meeting: Chairman Invited speaker Oral presentation Poster presentation Passive attendance Previous contribution to Rehab specialty or HKARM: ____________________________________ If I am selected to receive the sponsorship, I understand and agree that: Reimbursement will only proceed after the sponsor amount is duly received from the sponsoring commercial company. I will immediately notify HKARM if I cannot attend or finally have not attended the meeting. The sponsorship is not transferable to other person. It should be the decision of HKARM council. All expenses exceeding the sponsor amount will be borne by the applicant. I cannot accept other sponsorship or top-ups for the same event. A copy of the Certificate of Attendance will be sent to HKARM after the meeting. If you are unable to provide Certificate of Attendance and/or official receipts, please explain the reason(s) in the “Reimbursement Without Proof” form and the ultimate decision of reimbursement will be subjected to the final approval of the Council of HKARM. (For HA staff) I will approach my cluster HRD for the HA rules & regulations on accepting external sponsor. I may be invited and I agree to present “What is learnt from the meeting” in the Inter-Hospital Rehabilitation Meeting.
Applicant’s Signature: _________________________ Date: _________________ An administration fee of HK$200 in cheque made payable to the “Hong Kong Association of Rehabilitation Medicine” should attached with the application form and is non-refundable. Please send this form and the cheque to the following address: ----------------------------------------------------------------------------------------------------------------------------Attn.: Dr. CHU Chun Kwok, Angus (Honorary Secretary, Hong Kong Association of Rehabilitation Medicine) Room 9.029, 9/F, Rehab Block, Tuen Mun Hospital, N.T.
