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Thank you very much for making a donation to support The Hong Kong Polytechnic University.

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1. Donor Contact Details
Name of Donor:*
Please select title  Please enter donor name 
(e.g. CHAN Tai Man)
Name to be printed
on the receipt:

(If different from the above name or you want to use company name on the receipt.)
Mailing Address:* Please enter the mailing address
E-mail Address:* Please enter a valid email address
Telephone No:
I am PolyU alumni/student of department:

2. Amount of Donation
I would like to make a donation to The Hong Kong Polytechnic University.
The donation amount is: HK$ Please input the donation amount
Card Holder’s Name as shown on the Visa/Master/China Union Pay card:*

(e.g. CHAN TAI MAN )

3. Purpose of Donation
General University Development
Use by Academic Department  :
Other, please specify:

I acknowledge and agree that PolyU will apply for a grant that matches this donation from the University Grants Committee.
I wish to remain anonymous in donor listings.
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