HKCMA Membership Registration – Associate Member – The Hong Kong Chinese Medical Association

I would like to*

Apply as a new member

Renew my membership

Surname in English*

Given name in English*

Name in Chinese

Registration No. in the relevant regulatory body (if applicable)

Gender*

Male

Female

Contact:

Email*

Mobile Tel.*

WhatsApp on this number?

WhatsApp No. (if applicable)

Office Tel.*

Correspondence Address: *

Correspondence Address*

Office

Home

Full Address*

Type of Practice: (Please tick as appropriate ✓) *

Type of Practice*

Private

Public

Others

Type of Private Practice*

Hospital

Clinic

Others

Type of Public Practice*

HA

DH

University

Subvented organisation

Practice Type*

Name of institution*

Position*

Referred by:

Referrer*

Advocacy Concurremce*

I fully concur with the HKCMA LTD advocacy clauses.

Fee Declaration*

Membership fees are waived until 30 June 2024. I understand that to be an associate 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 Method

Pay by cheque

N.B.

Cheque payable to “Hong Kong Chinese Medical Association Ltd.” and post to 4/F, Duke of Windsor Social Service Building, 15 Hennessy Road, Wanchai, Hong Kong.
Associate Members are not voting members.

Personal 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.