Ocean Park
"Friend of the Ocean" Signature Brick Programme



Please print out the following form for your application.

SUPPORT FORM




Contributor's Name : ____________________________________





Date of Birth : ______________________ Sex : ____________





Address : _______________________________________________





          _______________________________________________





Telephone : _______________(office) ________________(home)


            


Return this application to the Park's Guest Relations


Office at either entrance with payment, or send by mail


to the Education Section, Ocean Park, Aberdeen, Hong Kong


with a crossed cheque payable to "Ocean Park Conservation


Foundation". This donation is tax deductible.





Please sign in the boxes below. This/These signature(s)


will be inscribed in the Ocean Park "Friends of the


Ocean" Signature Brick Wall for a one-year period.




Format  [_] Individual Signature


            line at HK $ 1,000.00


            (1/5 space of the brick


            per name)





        [_] Exclusive Signature 


            Brick at HK $ 5000.00


            (Take up the whole brick


            with a minimum of 1 name


            to a maximum of 5 names)





Payment [_] Cash       [_] Cheque





Donation Receipt Required:


        [_] Yes        [_] No





Date of


Application:________________________             













1. __________


Name(in block)








2. __________








3. __________








4. __________








5. __________














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