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Sinopec VIP Card Application Form
HK Federation of Trade Union – Private Vehicle
( For internal use only):
,
(Please complete this form in BLOCK LETTERS). FTU20140501 3499
: l l l l l l l l l l l l l l l l l l l l l
Name:
l l l l l l l l l l l ( 30
, Max. 30 characters, incl. spaces)
*: l l l l l l l l l l l l l l l l l l l l l
Mailing
l l l l l l l l l l l l l l l l l l l l l
Address
l l l l l l l l l l l l l l l l l l l l l
l l l l l l l l l l l l l l l l l l l l l
*( Mailing Address must be same as address proof)
:
Contact Numbers: l l l l l l l l l l / l l l l l l l l l l l
:
Email: l l l l l l l l l l l l l l l l l l l l l
:
Contact Person: l l l l l l l l l l l l 1.
(: )
2. ( ! " #)
( )
3. $ % & & ' ( ) * + & , -
..
(Please “” to indicate type of fuel) Please return application form with following
Gasoline Diesel
: copies:
Vehicle No.: l l l l l l l l l l l l l 1. Address proof (e.g. Electricity Bill).
2. HK Vehicle Registration Document(s).
3. Valid HK Federation Trade Unions membership
____________________________ _____________________________
HK Federation Trade Unions
& ' AS 2 U V 2
12, Ma Hang Chung Road, To Kwa Wan, KLN
Membership No.:______________ Application Date:_______________
Application for SINOPEC VIP card
W T 0 1 X Y Z [ Consent to Use of Personal Information ( Z [ # “Consent”)
V W X Y Z U [ M \ ]^ _` a 1 b c Bd e f g h Bi j\f k l m n /= > M o h Bi
j\/Bp q r l m n M o h Bi jstV W X u ; v w / 0 x D < :y Z U I @ A 9u _ z
{ _ | ]}. I T~ ( ) / 0 , : D V W X Z U I @ A , H _ z { _ | ]T
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We/Our company intend to use your name, telephone number and address for direct marketing or promote fuel products or
services, products and services offered in the convenience stores and/or filling stations but we cannot use your personal data
without your consent. Please sign at the end of this Consent to indicate your agreement to such use. Should you find such
use of your personal data not acceptable, please indicate your opt-out request before signing by “” ticking the appropriate
check box below and sign at the end of this Consent.
@ A
To: The Data Protection Officer
( )f k ? W X
SINOPEC (HONG KONG) PETROL FILLING STATION COMPANY LIMITED
28377 ] P. O. Box No. 28377, Gloucester Road Post Office, Hong Kong
Date___________________________________
H z { _ | ]}. I T~ * Please “” tick the appropriate check box below to indicate your choice*.
□ /V Z ? m M d e @ A B , tD H 5 6 ¡ ¢ \g h £
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We/I WISH to receive all of direct marketing materials or messages from the Company via all channels, including but not limited
to discount upgrades, complimentary products, promotions and privileges.
□ /V \ ] w ¤ W X ¥ _ m M d e @ A B
We/I DO NOT wish to receive any direct marketing materials or messages from the Company via the following channel(s):
± ² ³
Customer Name: ______________________________________________________________
]^ _____________________________________·¸ u E F ¹ º » ¼ w ½ º ¾
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Contact Numbers (Note: will use as contact if it is necessary for the processing of the opt-out request.)
± ² ( )
Customer Signature _____________________________________
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2. Î ÄÅ % ] [ é 'x ] % 0 2. The Company may be unable to establish or continue the credit facilities or
h v j ÄÅ ¾ ÄÅ [ [ to provide any products or services provided by the Company if customer fail to
M K L 2 3 provide such personal data to the Company.
4. ¼ Õ s t ÄÅ [ K B ! é ' \ % ½ 4. If the Company asked customers to provide their personal information, the
Æ ¾ gì é M 8 '` Þ X Z % 4 é 8 F Æ ¾ U ½ Company will always specify the purpose for which such personal information is
M 8 collected and ensure that It is only used for the purpose specified at the time of
collection.
5. | > M B ! é X ¿ ' x â : ´ å [ 5. Customers’ personal data held by the Company will be kept confidential but
ì é ^ À é Á â Â å the Company may provide such information or transfer such information to a
place outside Hong Kong to:
(a) F
Æ ¥ A ¡ ¢ d ª d 3
Æ Ã BK S q 3m (a) banks, debt collection agencies and other financial institutions in
=ä connection with the collection of payments;
(b) öª « d1Ä dÆ c df 8 Ý d¯Å d°± » Ü d° (b) any affiliate of the Company, agent, contractor or third party service
± ® ¯d 2 ² § B/ N O ² § d1Æ dÇ È É dc 3d provider who provides administrative, telecommunications, debt collection, credit
^ c F 3Ê " å 9 [ 2 3M d reference, advertising, market research, marketing, direct sale, and/or privilege
à !dù cË Ì Í å 2 3 [ ï ä contact calls, computer, information technology support, payment, transfer or
other services to the Company in connection with the operation of its business;
(c) F 3ª « d°± ® ¯ Î Ï « H ¿ L Ì Í å 'â ¶ Ä (c) business partners, allied and strategic marketing partners or specified third
Å 5 Ð ß ÄÅ x ] Ñ Ò Ó M M K L 2 3 ( cd parties in order to keep customers informed of products or services which the
dK C dF 3ª « @ ï M K L 2 3) ä Company believes may be of interest to customers (including products and
services of the Company, its affiliates and business partners or all of them);
(d) Ô Õ Ï : ¸ Ö 8 M Ì Í ï 2 3[ u ¡ c (d) external service providers (including but not limited to mailing houses,
d P F Ã Ä>
× d1Ä d16 ª § B § Ã telecommunications companies, telemarketing and direct sales agencies, call
!d16
× d é d6 d Ä Ø Ç ä centres, data processing companies, card issuance companies, information
technology companies) that the Company engages for the purposes
abovementioned;
(e) | X ¿ û ` = ù Ù | Ï : é X ¿ (e) any other person or organisation under a duty of confidentiality to the
M K S H ¿ !" m =ä Company which has undertaken to keep such information confidential; and
(f) ® Ú Y m =Û ¿ Ü - dK C B (f) any party to whom the Company, its affiliates and/or specified business
/ F 3© ª « ¬ é M !" partners is/are required or permitted by law or any regulatory authority to make
disclosure.
6. Ý ÄÅ [ M B ! é 8 F 2 ² § 6. The Company intends to use the personal data in direct marketing and the
8 ' ( 8 5 Q ÄÅ M T Í cd - J P Þ |
ö Company requires customer’s consent (which includes an indication of no
g', ß Í objection) for that purpose. In this connection, please note that:
(a) x ] P U > M ÄÅ e K à dC f (a) the full name or any part thereof, contact details, products and services
é dK LB2 3á © é d. ø â æ Bª dq 3ã ä B portfolio information, transaction pattern and behaviour, financial background and
!! p é 8 F 2 ² § ä demographic data of customers held by the Company from time to time may be
used by the Company or group company in direct marketing.
(b) x 8 F ² § å µ © 2 3dK LB² § æ M (b) the following classes of services, products and subjects may be marketed:
(i) µ © K Lä (i) petroleum products;
(ii) K LB2 3ä (ii) card related products and services;
(iii) ç Ñ è Ü é ê 2 3B / È K Lä (iii) car beauty or maintenance service and/or related products;
(iv) ê ë dÄÅ % &
dC Ê LÒ ©
dN O
(iv) reward, loyalty, co-branding or privileges programs and related products
BÈ K LB2 3ä and services;
(v) © M C Ê LÒ © ª « [ L K LB2 3 (v) services and products offered by the Company’s co-branding partners (the
ì ª « M 4 F 2 3BK L+ , - Ï å äB names of such co-branding partners shall be provided in the application form(s)
for the relevant services and products, as the case may apply); and
(vi) â ì W B / a í É î M ì W B/ a í É ï < (vi) donations and contributions made to charitable and/or non-profit making
m = [ M ð ñ ð ò organizations for charitable and/or non-profit making purposes.
(c) Ï : 2 3dK LB² § æ M x ] B/ â (c) the abovementioned types of products, services and subjects may be
¡ öð ñ ð ò ó ô t provided or (in case of donations and contributions) solicited by the Company
(i)
¾ ï $ & ä and/or:
(ii) Ì Í å q 3m =dù X !df 8 d È K L (i) any other member or group companies of the Company or Sinopec;
[ u Ë dõ ö ¸ L[ u Ë dç Ñ è Ü 2 3[ u Ë dç Ñ é ê (ii) third party financial institutions, insurer, credit card companies, petroleum
2 3[ u Ë ä related products suppliers, consumer goods suppliers, car beauty service
providers, car maintenance service providers;
(iii) Ì Í å ê ë dÄÅ % &
dC Ê LÒ ©
N (iii) third party reward, loyalty, co-branding or privileges programs or other
O
[ u Ë äB related services and/or product providers; and
(iv) ì W B/ a í É ï < m = (iv) charitable or non-profit making organizations.
(d) P ² § Ï : K Ld2 3B² § æ M â Â ' (d) in addition to marketing the above products, services and subjects, the
e Ý 4 â Ï Ì 5(a) @ BM é [ â Ï µ © m =â Company also intends to provide the personal data referred to in Clause 5(a)
[ S ÷ o ² § ì K Ld2 3B² § æ M
; 8 ' herein for use by them in marketing those products, services and subjects, and
g8 ( 5 Q ÄÅ 8 9 T Í cd - J P Þ |
the Company requires the customer’s written consent (which includes an
indication of no objection) for that purpose.
(e) ´ ÄÅ P ø ù ´ Ï : ; 8 K é 4 K (e) If any person does not wish the Company to use or provide to other
é [ K S !" 2 ² § 8 'ÄÅ x â ª persons his data for use in direct marketing as provided in this Clause, he may
; K ú û á { ² § exercise his/her opt-out right by notifying the relevant company.
7. G % ; 8 ÄÅ é Ï : Ì 3d 4 B 5
: M 7. The Company will only use customer data for purposes set out in
8 ä 4 ü K ] X ý ÄÅ M B ! é 'þ % 5 paragraphs 3, 4 and 5 above and the Company will use its best endeavour to
- M Í Â Ü d P secure customer data against unauthorized, accidental access, processing or
erasion.
8. ÄÅ s t Ü ¼ Y K B ! é ' Ü 8. Customer has the right of access to or correction of his/her personal data or
> L B ! é M µ © d« R ª + 'cd information held by the Company or information regarding policies and practices
and types of personal data held by the Company including:
(a) Ü U > K B ! é '` ê d¼ Y P (a) to check if the Company retain his/her personal data and to update, correct
é ä or erase such data;
(b) 5 Q µ Æ c df 8 Ý d°± ® ¯dª « Ï Ì 3
(b) to obtain information on items of data about customer which the Company
: 8 ' x ] 4 F ÄÅ M B ! é Ï Ì 4 may disclose to third party described in paragraph 3 above for debt collection,
: L Ì Í å ¬ L é µ © ä credit reference, marketing, administrative purposes or other purposes set out in
paragraph 4 above;
(c) Ü ì 2 3 [ ï B/ F 3ª « Ì Í å > ÄÅ (c) to access to data in relation to the relevant customer so held by those third
M B ! é '` ê ¼ Y K B ! é Ü äB parties, service providers and/or business partners and to update and correct
such data; and
(d) dK C BF 3ª « 5 Ç ® ¯ é (d) to discontinue receiving marketing information from the Company and/or
any of its affiliates and business partners.
ì s t \ u â 8 9 ç æ I ` , > Á â Any such request should be in writing and forwarded to the following address:
9. | ÄÅ B ! é M X ' U } 'P % v F 9. Customer’s personal data will only be retained by the Company for as long
3 õ ® s t M U } as necessary for the fulfillment of its business needs or legal requirements.
10. X Ã É öÜ B ! é ã ª M õ [ Æ 10. The Company reserve right to charge a reasonable fee for the request and
Ç © 7 8 processing of any data access.
11. « H ` P i ÄÅ y z @ + I M É 11. Nothing in this Policy Statement shall limit the rights of customers under the
Ordinance.
12. ÄÅ x ò U ú û P 2 Æ 6 I M § ® 12. Any customer may, at any time and without charge, choose not to receive
¯ é N O ² § C D 16 ', 4 ) * M - . / any direct marketing material from the Company by returning the form with
% F 7B S l ÄÅ H J 'P Æ Ç 7 8 ' relevant information to us, customer will always have an opportunity to opt-out.
` Þ X Q M 2 & d1 é P 6 ÄÅ 'Ä The Company will then, at no cost to customers, act on their request within 7
Å e P % Æ Á N O ² § M 16 C D working days and ensure that customer is not included in future direct marketing
promotions or privilege contact call list.
13. ´ « L
| ~ T 'â
13. In case of discrepancies between the Chinese and English Versions of this
Policy Statement, the Chinese Version shall prevail.