Ggggg-Unit

In: Novels

Submitted By james69
Words 604
Pages 3
Anyplex 存根

Anyplex Service Application Form 數碼點播服務申請表格
Please fill in the following in BLOCK LETTERS and put a “” in the appropriate box. 申請人必須以英文正階塡寫表格及在適當方格內加上“”號。 I would like to apply for silver membership. No monthly fee 本人欲申請銀會籍。 No pre-pay Silver member entitlements 銀會籍所享服務: 無月費 1) Free 3 days trial (Except for AV movies) 無預繳 3 天免費試用 (成人電影除外) 2) Pay per view 按用戶觀賞電影價目及數量收費



 I hereby agree that Anyplex Hong Kong Limited has the right to charge my credit card account for the purchased services in regular manner as agreed upon by me and Anyplex Hong Kong Limited. The recurring transaction will not be terminated until Anyplex Hong Kong Limited has been informed by my written notification of service termination. I agree the validity of this agreement will continue before or after the expiry date of the credit card account. 本人同意並授權 Anyplex Hong Kong Limited 由本人下列信用卡 賬戶定期收取本人與 Anyplex Hong Kong Limited 協議使用的服 務之費用。 是項授權除非得到本人的書面通知或服務受到終 止,否則於信用卡有效期屆滿後仍然有效。 Card Type 信用卡種類: VISA  MasterCard 萬事達卡 M月 Y年

Upgrade Service Plan 升級服務計劃

 Gold member 金會籍

HK$ 20/mth
每月港幣 20 元

Expiry Date 有效期至

Gold member entitlements 金會籍所享服務: 1) Free 3 days trial (Except for AV movies) 3 天免費試用 (成人電影除外) 2) Unlimited watch ‘Gold Member Selection’ videos 無限量觀賞 ‘金會籍精選’ 影片 3) 20% off discount for other pay per view videos 8 折點播其他影片

Cardholder’s Name (If different from subscriber’s name) 信用卡持有人姓名 (如與上述訂戶姓名不同)

Card No. 信用卡號碼 Credit Card Issuing Bank 信用咭發卡銀行 _________________

Personal Data 個人資料
Applicant must be a Hong Kong residence aged 18 or above. 申請人必須為年滿 18 歲之香港居民。  Mr. 先生  Mrs. 太太  Ms. 女士  Miss 小姐

Name in English (In BLOCK LETTERS) 英文姓名 Please imprint credit card here Name in Chinese 中文姓名 Mobile Phone No. 手提電話 (Login Name 登入名稱) Date of Birth 出生日期 D日 M月 Y年 X X X (X) 請刷卡

x

_____________________________________________________ Cardholder’s…...

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