香 港 數 學 學 會

The Hong Kong Mathematical Society		

EMAIL: djfeng@math.cuhk.edu.hk		    URL: http://www.hkms.org.hk	

APPLICATION FOR MEMBERSHIP

APPLICANT:
I, the undersigned, hereby apply for 

		Full membership†  	

		Associate membership  	

		Student membership  	

of the Hong Kong Mathematics Society and certify that the information given by me in this application is correct 

Date : ____________________________ 	Signature : ________________________ 
† Full members will automatically become members of SEAMS free of charge. If you wish to opt out, please sign your objection here __________________ or you may do so at any other time, by sending your formal objection to the membership secretary. 

PROPOSER: 
I, the undersigned, propose that the applicant be elected a * Full Member / an Associate Member / a Student Member of the Society.  This proposal is based on my personal knowledge of * him/ her and of * his / her achievement in Mathematics. 

Name : ____________________________ 	Signature : ________________________ 

SECONDER: 
I, the undersigned, second the above proposal, on the basis of my personal knowledge of the applicant and * his / her achievement in Mathematics. 

Name : ____________________________ 	Signature : _________________________
*Please delete the inappropriate. 

FOR OFFICIAL USE ONLY
This application is * approved / rejected by the committee.
REMARKS : 	_______________________________________________________________

Date : ____________________________ 	Signature : _________________________
Please complete the reverse side 

PARTICULARS OF APPLICANT

A.	PERSONAL PARTICULARS 

NAME					
	SURNAME	OTHER NAMES		NAME IN CHINESE	

DATE OF BIRTH		/		/			SEX		
	DAY		MONTH		YEAR				

PLACE OF BIRTH		NATIONALITY		

OCCUPATION		POSITION		

BUSINESS ADDRESS		

OFFICE TEL		HOME TEL.		

FAX		EMAIL.		

URL		

RESEARCH INTERESTS		

B.	QUALIFICATIONS 

DEGREE/DIPL./CERT.	INSTITUTION	SUBJECT	YEAR OF AWARD	

				
OTHER QUALIFICATIONS/ACHIEVEMENT: 

FOR STUDENT MEMBERS ONLY 

INSTITUTION	COURSE PURSUED	CLASS/YEAR/STAGE	MAJOR	YEAR	

					

REMARKS: in support of the application (including details of published work, theses, etc.)