家居空氣質素檢測計劃報名表 Home Air Quality Measurement Enrollment Form
填妥以下表格則有機會獲得免費居住環境空氣質素測試
Sign up to get a chance for free home air quality measurement
您是通過何種方式得知這份報名表? Which channel did you get this enrollment form? *
您屬於哪一類人群? Which group do you belongs to? *
您住在哪一區? Which district do you live? *
您居住的房屋類型? Which type of house do you live? *
您住宅的實用面積 (呎)? What is the size of your housing saleable area (square feet)? *
您所住的房屋於何時建成的? When was your home building being built? *
您所住大樓總共有多少樓層? How many TOTAL floors at your resided building? *
可否告知您所住大樓名稱? Can you tell us the name of your resided building?
Your answer
聯絡資料 Contact Information
姓名 Your name
Your answer
電郵 Email
Your answer
電話 Tel
Your answer
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