BUILDING & TOILET ACCESS CARD APPLICATION FORM

BUILDING & TOILET ACCESS CARD APPLICATION FORM

[ CP-MK-FM010 (Rev.3) ]

"*" indicates required fields

CENTRAL PLAZA

BUILDING & TOILET ACCESS CARD APPLICATION FORM

To : Central Plaza Management Co. Ltd.
[ Suite 2802, Central Plaza / fax no.: 2136 8999 ]
From
Contact Person*

RE : APPLICATION FOR BUILDING & TOILET ACCESS CARD

1. Name*
Please provide the first 4 digits including the letter, e.g. K123XXX(X).
Toilet Access Function*

2. Name
Please provide the first 4 digits including the letter, e.g. K123XXX(X).
Toilet Access Function

3. Name
Please provide the first 4 digits including the letter, e.g. K123XXX(X).
Toilet Access Function
4. Name
Please provide the first 4 digits including the letter, e.g. K123XXX(X).
Toilet Access Function

We understand and agree to pay HK$200.00 per building access control card and / or HK$50.00 per toilet access card for lost or damaged card. For void card (refers to any mal-function access card except those due to improper use by cardholder), the card will be replaced free of charge.
Company Chop*
Accepted file types: jpg, jpeg, png, gif.
This field is for validation purposes and should be left unchanged.