□ 本人 / 本機構願意捐助港幣 _____________ 元予「香港青年協會」。
I / My organization am / is interested in donating HK$__________ for The Hong Kong Federation of Youth Groups.

劃線支票抬頭註明： 香港青年協會
Crossed Cheque made in favour of“ The Hong Kong Federation of Youth Groups”:

支票號碼Cheque No.: ______________________________________

捐款人姓名Name of Donor: ______________________________________
贊助機構名稱Name of Sponsoring Organization: ___________________________________
聯絡人Name of Contact Person: _________________________________________________
聯絡電話Tel. No.: __________________ 傳真號碼Fax No.: __________________________
地址Correspondence Address: ___________________________________________________
____________________________________________________________________________

所有超逾港幣$100的捐款，將獲發回收據，並可作申請扣稅之用。
Receipts will be issued for all donations over HK$100 and are tax-deductible.

捐款表格及劃線支票敬請寄回：
Please send this donation / sponsorship form with the crossed cheque to:

「香港青年協會」伙伴及資源拓展組
香港灣仔軒尼詩道19-21號金鐘商業大廈9字樓

The Hong Kong Federation of Youth Groups
Partnership and Resource Development Office
9/F, Kam Chung Commerical Building, 19-21 Hennessy Road, Wanchai, Hong Kong.