HKMHDIA Executive Board Inauguration Ceremony cum Gala Dinner 2018 (Tables Purchase)
Date: 3 December 2018 (Monday)
Time: 5:30pm - 10:00pm
Venue: ClubONE, G/F, Building 12W, No.12 Science Park West Avenue, Hong Kong Science Park, Shatin, N.T. HK
Title *
Name (eg. Peter Chan Dai Ming) *
Your answer
Company Name *
Your answer
Position
Your answer
Email *
Your answer
Phone Number *
Your answer
Company Address
Your answer
No. of Table(s)
Your answer
No. of Seat(s)
Your answer
Total Payment *
Your answer
Guest(s) Name (if any) (eg: 1. Peter Chan Dai Ming, 2. Andy Chan Siu Ming, etc......)
Your answer
Declaration聲明
I declare that all information provided in this enrolment form and the attached documents are, to the best of my knowledge, accurate and complete.
本人聲明在此報名表格及隨附文件所載的資料,依本人所知均屬完整真確。
Consent statement同意聲明
Personal data (including your name, phone number, fax number, correspondence address and email address) provided by you will be used for the purpose of the administration, evaluation and management of your registration. You have the right to request access to, and amend your personal data in relation to your application. If you wish to exercise these rights, please send email to: edm@medicaldevice.org.hk.
閣下提供之個人資料(包括姓名、聯絡電話、傳真號碼、通訊地址和電郵地址)將會用於處理、評估和管理閣下登記出席本活動之用。閣下有權查閱及修正閣下就你的申請所提供的個人資料。如有需要,請發電郵至 info@medicaldevice.org.hk

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