To download the form in Word format, please click here.
 
* Mandatory Field
  Personal Particular
  Title (Mr/Mrs/Miss/Ms/Dr) :    
  Name (English) : *  
  Surname (English) : *  
  Given Name (English) : *  
  Name (Chinese) :  
  HKID Number :  
  Date of Birth :   / /
  Gender :  
  E-mail Address : *  
  Phone (Home) : *  
  Phone (Office) : *  
  Phone (Mobile) : *  
  Degree : *  
  Graduation Year : *  
  Address (Home) : *  
  Company :  
  Capacity :  
  Address (Office) :  
  Are you a HKU Graduate? *  
  If not, please specify your College/University  

  Membership *
   

  Membership Payment Method *
   

Note:
1.

By Cash - please deposit to HSBC account 582-355152-001 "HKUGA" and fax the bank pay-in slip to our fax: 3012 9925

 
2.

By cheque - please make payable to "HKUGA" and mail it to our address 17/F, Jie Yang Building, No 271 Lockhart Road, Wanchai, Hong Kong


Cheque No.:

 

 

Remarks (Please inform us any special request in the following box. If you apply couple membership, please fill-in the name of spouse in here.)