【法规名称】
【法规编号】 44030 什么是编号？
【正 文】
第8页 CAP 359F OPTOMETRISTS (REGISTRATION AND DISCIPLINARY PROCEDURE) REGULATION
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[接上页] REMARKS : ................................................................................................... ................................................................................................... Photograph ............................................. Secretary, Optometrists Board. (Enacted 1994) Cap 359F Sched 2 [sections 7, 9, 14, 23 & 42] FORM 1 [section 7(1)] SUPPLEMENTARY MEDICAL PROFESSIONS ORDINANCE (Chapter 359) OPTOMETRISTS (REGISTRATION AND DISCIPLINARY PROCEDURE) REGULATION Application for Registration/Provisional Registration as an Optometrist I ............................................................................................................................... of (name in both English and Chinese) .................................................................................................................................... being (correspondence or home address) qualified for registration under section 12(1)*(a)/(b)/(c)/section 15 of the Supplementary Medical Professions Ordinance apply for *registration/provisional registration as an optometrist and request that my name be placed on Part .................... of the Register. 2. I hold the following qualifications (please state qualifications obtained in chronological order): Qualification Issuing Authority Date Issued 3. I have the following professional experience (please state professional experience obtained in chronological order): Post Title Name of Organization/Company Period From To 4. My business address(es) *is/are as follows: (English) ............................................................................................................................... ............................................................................................................................................. (Chinese) .............................................................................................................................. ............................................................................................................................................. 5. My telephone numbers are ................................. (Home) .................................. (Office). 6. I *+have/have not been convicted in Hong Kong or elsewhere of an offence punishable with imprisonment. I *have/have not been found guilty in Hong Kong or elsewhere of unprofessional conduct. I *am/am not the subject of an existing order under section 22(1)(i) or (ii) of the Supplementary Medical Professions Ordinance. I declare that the information given in this application is correct to the best of my knowledge and belief. Signed at .................................................. ｝ ............................................................... the ............... day of ...................... 19 ..... (Signature of Applicant) Before me, ............................................................. .............................................................. (Name in block letters) (Signature) * Optometrist registered in Part I of the Register/Barrister/Solicitor/Registered medical practitioner/Registered dentist/Commissioner for Oaths. Photograph of Applicant + Please supply details of conviction. * Delete as inappropriate. (47 of 1997 s. 10) FORM 2A [section 9(1)] OPTOMETRISTS BOARD HONG KONG SUPPLEMENTARY MEDICAL PROFESSIONS ORDINANCE (Chapter 359) Certificate of Registration Number of Register: ...................... This is to certify that ...................................................................................................... whose address is ................................................................................................................... and whose photograph appears hereon was on the ............... day of ......................... 19 .......... admitted to Part ............ of the Register of Optometrists. Dated this ........... day of ....................... 19 ......... Photograph ........................................... Secretary, Optometrists Board. (L.N. 88 of 2004) FORM 2B [section 9(2)] OPTOMETRISTS BOARD HONG KONG SUPPLEMENTARY MEDICAL PROFESSIONS ORDINANCE (Chapter 359) Certificate of Provisional Registration Number of Register: .................... This is to certify that ...................................................................................................... whose address is ................................................................................................................... and whose photograph appears hereon was on the ............... day of ........................ 19 ........... admitted to Part IV of the Register of Optometrists subject to the undermentioned conditions. Conditions imposed pursuant to section 15(3) of the Supplementary Medical Professions Ordinance- Dated this ............ day of .................... 19 ........ Photograph |
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