Honour With Books - e-Forms

Book Title: *

Call Number: (optional) Not required for e-book

Donor Information

Your Name: *

Salutation: *

Dr Ir Ir Dr Ir Prof. Miss Mr Ms Prof.

Contact Address: *

Email: *

Phone No.: *

Status: *

Faculty Staff Student Alumni Others

Student No.: (optional) Required for student.

Year of Graduation: (optional) Required for alumni.

I wish to remain "Anonymous" on the Library Newsletter's donor list.

My Bookplate Preference

Design Category: *

General Graduation

Design: *

Occasion: *

In Honour of In Memory of In Celebration of

Honouree Name: * To appear on the bookplate.

Honouree Salutation: (optional)

Dr Ir Ir Dr Ir Prof. Miss Mr Ms Prof.

To appear on the bookplate.

Bookplate Text in Exact Wording: (optional) Not more than 80 English characters (PolyU Library reserves the right to modify the text of the donated bookplate). Examples for reference: 21st Birthday, Graduation in November 2020

Dedicated by: (optional) To appear on the bookplate.

Date: (optional)

Payment Method

Cheque

Payroll Deduction

Credit Card

Payment instruction will be given upon submission.

Staff No.: (optional) Required when selected to pay via payroll deduction.

I want to receive a receipt for tax exemption.

Acknowledgement

Yes! I acknowledge and agree that The Hong Kong Polytechnic University will apply for a grant that matches this donation from the University Grants Committee.