To: Health, Safety and Environment Office

To: Health, Safety and Environment Office

by email:

Deadline of Submission: 14 October 2016 (Friday)

Entry Form for HSEO Logo Design Competition for Safety Week 2016

Part A: Information of Participant

Name in English: / Name in Chinese:
Phone Number: / Email:

(for student and staff)

Staff/Student ID: / Department/Unit:
Programme (for student only): / (Year )

(for alumni)

Year of Graduation: / Programme:

Part B: Design Concept (Description in around 200 words)

Part C: Declaration

□ I declare that the entry is my own creation. I have read, understood and accepted the terms and conditions in this competition. *

* Please tick where appropriate

For enquiries, please feel free to contact HSEO by calling 3400 8419 / 3400 8404 or by e-mailing to .