COVID-19 Declaration Form

1
Role* This field is required.Are you a student or a member of staff?
Student
Staff
2
Select territory* This field is required.
Hong Kong Island
Kowloon
New Territories
3
Select HK Island centre
西營盤 / Sai Ying Pun [BE01]
北角 / North Point [BE02]
鯉景灣 / Lei King Wan [BE08]
康怡 / Kornhill [BE23]
香港仔 / Aberdeen [BE28]
銅鑼灣 Causeway Bay [BE29]
杏花邨 / Heng Fa Chuen [BE32]
4
Select Kowloon centre
黃埔花園 / Whampoa Garden [BE04]
美孚 / Mei Foo [BE06]
藍田 / Lam Tin [BE12]
黃大仙 / Wong Tai Sin [BE14]
九龍灣 / Kowloon Bay [BE15]
大角咀 / Tai Kok Tsui [BE18]
荔枝角 / Lai Chi Kok [BE26]
紅磡 / Hung Hom [BE31]
土瓜灣 / To Kwa Wan [BE34]
太子 / Prince Edward [BE36]
5
Select New Territories centre
馬鞍山 / Ma On Shan [BE03]
坑口 / Hang Hau [BE05]
石門 / Shek Mun [BE07]
元朗 / Yuen Long [BE09]
元朗峻巒 / Yuen Long Park Yoho [BE10]
荃灣 / Tsuen Wan Belvedere Garden [BE11]
調景嶺 / Tiu Keng Leng [BE13]
火炭 / Fo Tan [BE16]
荃灣西 / Tsuen Wan West (OP Mall) [BE17]
粉嶺 / Fanling [BE19]
大圍 / Tai Wai [BE20]
屯門 / Tuen Mun [BE21]
青衣 / Tsing Yi [BE22]
將軍澳 / Tseung Kwan O [BE24]
天水圍 / Tin Shui Wai [BE25]
大埔 / Tai Po [BE27]
上水 / Sheung Shui [BE30]
屯門南 / Tuen Mun South [BE33]
愉景新城 / Tsuen Wan (Discovery Park) [BE35]
葵涌 / Kwai Chung [BE37]
6
Full name* This field is required.
7
I declare by signing below that the name stated in this form has returned a negative COVID-19 RAT test prior to entering the learning centre at the date and time of submitting this form. * This field is required.
Clear
Should be Empty: