I would like to*Apply as a new memberRenew my membership Surname in English* Given name in English* Name in Chinese Gender*MaleFemale MCHK Reg. No.* Speciality Name of Medical School* Year of Graduation*Contact: Email* Mobile Tel.* WhatsApp on this number?WhatsApp on this number? WhatsApp No. (if applicable) Office Tel.*Correspondence Address: * Correspondence Address*OfficeHome Full Address*Type of Practice: (Please tick as appropriate ✓) * Type of Practice*PrivatePublicOthers Type of Private Practice*SoloPartnershipGroupHMO Type of Public Practice*HADHUniversitySubvented organisation Practice Type*Referred by: Referrer*Name of ReferrerDr Jane CHAN 陳真光醫生Dr CHEUNG Hon Ming 張漢明醫生Dr Daniel CHU 朱偉星醫生Dr KONG Yim Fai 江炎輝醫生Dr Carol KWOK 郭子熹醫生Dr Samuel KWOK 郭寶賢醫生Dr David LAM 林哲玄醫生 Dr Geroge LAU 廖家傑醫生Dr LAW Yim Kwai 羅炎逵醫生Dr Adrian LEUNG 梁漢邦醫生Dr LIU Shao Haei 劉少懷醫生Dr Siu Kwan NG 吳少君醫生Dr Loletta SO 蘇潔瑩醫生Dr Michael SUN 孫文堅醫生Dr Ludwig TSOI 蔡振興醫生Dr Veronica WAI 韋玉珍醫生Dr Anna WONG 黃敏菁醫生Dr Henry YEUNG 楊超發醫生Dr Betty YOUNG 楊海珈醫生Dr Cissy YU 余詩思醫生 Advocacy Concurremce*I fully concur with the HKCMA LTD advocacy clauses. Fee Declaration*Membership fees are waived until 30 June 2023, and are payable annually at HKD 500. I understand that to be a voting member of the HKCMA LTD, I am obliged to pay the annual membership fee in accordance with the annual review by the Board of HKCMA LTD.Please consider making an extra donation. I am happy to make an additional one-off donation to support the activities of the HKCMA LTD for (HKD): Payment MethodPay by chequePersonal Information Collection Statement:We will use the personal data you provide in this form for the following purposes: contacting you by email, SMS, or mail regarding our activities; and preparing statistics. This data may only be disclosed to parties where you have given consent to such disclosure or where such disclosure is allowed under the Personal Data (Privacy) Ordinance. You have the right of access and correction with respect to your personal data as provided for in Sections 18 and 22 and Principle 6 of Schedule 1 of the Personal Data (Privacy) Ordinance. Your right of access includes the right to obtain a copy of your personal data.SUBMITReset