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會員註冊表格
會員註冊
加入成為會員,一起參與活動,活出精彩人生。
Leave this field blank
Last name(Chinese)中文姓氏
First name(Chinese)中文名字
Last name英文姓氏
First name英文名字
Gender性別
Male
Female
Other
Birthday出生日期(dd/mm/yyyy)
Contact Number聯絡電話
Email address電郵
Age Group年齡組別
Below 10
10-20
21-30
31-40
41-50
51-60
61-70
70+
Guardian監護人姓名(applicant aged below 16 only只適用16歲以下申請人)
(optional)
Guardian Contact Number監護人聯絡號碼
(optional)
Guardian Email address監護人電郵
(optional)
District居住地區
Member Status會員分類
Cancer Patient/ Survivor 癌症病人/康復者
Ex-mentally ill精神復元人士
Special Educational Needs Student特殊教育需要學生
Other illness people 其他病患者
Relatives/Friends家人或朋友
Others其他
How Did You Hear About Us認識本會途徑
Friends
Family
Social Media (Facebook, Instagram, etc.)
Online Search
Advertisement
Event/Workshop
Are You Willing to Volunteer願意成為義工
Yes
No
Contact Method通訊方式
Mobile
Email
Mail
Whatsapp
I agree to allow this site to store and process the personal information submitted.
本機構會員制度:病患者會員免費,家屬/朋友/其他為附屬會員,年費港幣20元。會員年度為每年4月1日至下年3月31日,請把付款收據whatsapp:5232 3194至本機構查收,本機構會發出收據以確認會員資格。感謝你的申請及支持。
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