Part 5: Declaration

* Questions that are required to be answered

Criminal conviction *

Choose 1 option

I declare that I have no previous criminal conviction whether in Hong Kong or elsewhere.

I declare that I have had previous criminal conviction(s) in Hong Kong or elsewhere (please provide details)

Conviction on sex crime *

Choose 1 option

I declare that I have no previous conviction on sex crime whether in Hong Kong or elsewhere.

I declare that I have had previous conviction(s) on sex crime in Hong Kong or elsewhere (please provide details)

Physical and mental health *

I declare that I am in good physical and mental health.

Information and declaration *

I confirm that the information provided and declaration made by me in this enrolment form are true and accurate. I agree to provide supplementary information relevant to this application as requested by the Secretariat of the Commission on Poverty and / or The Salvation Army.

Authorisation of publication of photographs / videos *

I acknowledge and agree that the organiser may take photographs / videos which could include images of me during the Programme. I hereby grant the right, permission and authority to the organiser to use, publish, broadcast or otherwise disseminate, in any and all media worldwide, my name and any such photographs, motion pictures and/or recordings for any legitimate purpose(s).

Terms and Conditions *

I have read, understood and agreed with the terms and conditions herein

Personal Information Collection Statement *

Your personal information collected will be used solely for purposes in relation to the “Future Stars Mentoring Programme" (the “Programme”) of the Commission on Poverty, including but not limited to the daily operation and management of the Programme, matching of mentors and mentees and communication between you, your paired mentee(s) and service provider of the Programme. All personal data provided is entitled to the protection of the Personal Data (Privacy) Ordinance. Please refer to the ‘Personal Information Collection Statement for the Future Stars Mentoring Programme’ for details.

I have read, understood and agreed with the ‘Personal Information Collection Statement for the Future Stars Mentoring Programme’