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Workers Registration Office Application Form for Construction Workers Registration WRO-001(E) 2014/11/17 rev1b Guides on completing this application form: 1. Before filling in this application form, please read carefully the “Guidance Notes on Completing Application Form” and the Declaration printed on this form. 2. Please complete the form in English, except the Chinese name of applicant. 3. Please use ballpoint pen or pen, of either black or blue ink, to complete this form. Personal Information Collection Statement 1. The information you provide to the Construction Industry Council (the CIC), including any personal data as defined in the Personal Data (Privacy) Ordinance (the Ordinance), will be used solely for purposes related to the activities of the CIC. 2. To keep you informed of CIC activities and industry developments which may be of interest, the CIC would like to use your personal data, including your name, phone number and correspondence and email addresses, to update you in relation to training courses, trade testing, registration, events and other aspects of its work and the construction industry. 3. You are free to decide whether you wish to receive such information. If you choose not to do so, please put a tick in the box below. 4. You are also entitled to request access to and correction of any errors in your personal data. If you wish to do so please write to the CIC at 15/F, Allied Kajima Building, 138 Gloucester Road, Wanchai, Hong Kong. I do not wish to receive any information from the CIC in relation to its activities or developments in the construction industry (1) Personal Data (Personal particulars must be consistent with that on HKID Card) Name: (English) (Chinese) Sex: HKID Card No.: ( ) Date of Birth: (YYYY) (MM) (DD) Address: District: Telephone No.: (Home) (Mobile) Are you subject to any conditions of stay or employment in Hong Kong No ( I am a Hong Kong Permanent Resident; Holder of One Way Exit Permit;or Others (please state): ) Yes (Passport/Travel Document No.: Expiry date of employment visa: Issuing Country: YYYY/MM/DD) (2) Information on Mandatory Basic Safety Training (Green Card) (“Green Card” refers to the relevant certificate for completion of a safety course as defined in section 6BA(2) or certificate of exemption for completion of a relevant safety training course as stipulated in section 6BA(4) of the Factories and Industrial Undertakings Ordinance, Chapter 59) Green Card No.: Expiry Date: (YYYY/MM/DD) Issued by: (3) I would like/would not like to align the expiry dates of “Workers Registration Card” & “Green Card”./ Not applicable to “Alignment of Expiry dates” (Only applicable to New registration, Card renewal and Green Card with validity more than 18 months, please read Item 7 of the “Guidance Notes on Completing Application Form” for details. Applicants who apply for “Alignment of Expiry dates” are still required to renew the green card upon its expiration) (4) Application for registering as a: Registered Skilled Worker or Semi-skilled Worker including provisional registration (Please provide details in the table overleaf) Registered General Worker (Please skip the table overleaf) Declaration of Applicant 1. I have carefully read over the “Guidance Notes on Completing Application Form” and all other information printed in this application form. 2. I declare that all information given by me on this application form and documents submitted with this application are, to the best of my knowledge, true and correct. I understand that giving false information or making false statements knowingly and wilfully is an offence under the law and may result in the application being deemed to be invalid. 3. I have also authorized the Council to acquire information about my qualifications from the issuing organizations concerned and to verify my qualifications. For Registration Office Use Signature of Applicant: Date: Application No.: This form has been checked by: Date:
