香港馬凡氏綜合症協會入會申請表 Hong Kong Marfan Syndrome Association Membership Application Form
本會於2008年8月正式註冊為非牟利病人自助組織,由馬凡病友、家屬及支持者組成,旨在提高患者、醫護人員及公眾對馬凡病的警覺性,發揮助人自助精神,推廣義工服務及社會共融,以達致拯救患者生命、改善醫療、提升病友及家屬生活質素的目標。本會獲醫護翹楚及專業人士支持組成顧問團;日常營運由病友及家屬組成的執行委員會義務推動。歡迎馬凡病友、家屬及支持者加入本會。

Hong Kong Marfan Syndrome Association is a registered non-profit organization, formed in August 2008 by patients with Marfan Syndrome, their families and supporters. The Association aims to raise Marfan awareness among patients, healthcare professionals and the general public; promote self-help, mutual support, volunteer spirit and social integration; and improve healthcare for, and quality of life of Marfan patients and their families. Daily operation is managed by our Executive Committee, consisting of volunteer Marfan patients and family members, and supported by a group of honorary advisors who are prominent healthcare experts and professionals. All Marfan Syndrome patients, family members and supporters are welcome to join our Association.

閣下的個人資料將會絕對保密,只作本會內部使用。成為本會會員後,如閣下同意,歡迎加入馬凡Whatsapp群組,與眾病友及家屬互相支持,並接收有關馬凡病及本會活動最新資訊。

Your personal data will be kept strictly confidential and will only be used for our internal use. Upon joining as a member of Hong Kong Marfan Syndrome Association, and with your consent, you are welcomed to join Marfan Whatsapp group, to get in touch with fellow Marfans for mutual support, and receive relevant news about Marfan Syndrome and the Association’s latest activities.

欲加入本會,請先填寫下列申請表,然後將一次性會費$50,經銀行轉賬/現金存入本會的中國銀行(香港)戶口 012-875-0-040655-8,並將入數紙副本電郵至hkmarfan@gmail.com,請註明申請者姓名及手機號碼。本會將經Whatspp傳送會費收據予閣下。

To join, please fill in the online application form, and bank transfer/cash deposit HK$50 one-off membership fee to the Association's Bank of China (Hong Kong) account 012-875-0-040655-8. Please email a copy of the deposit slip to hkmarfan@gmail.com, indicate your name and mobile number, we shall Whatsapp you the receipt accordingly.
姓名Name *
性別Gender *
出生日期Birth Date *
MM
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DD
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YYYY
電郵Email *
手提電話號碼Mobile No. *
是否願意加入馬凡Whatsapp群組? Do you want to join Marfan Whatsapp group?
Clear selection
地址Address *
本人是 I am: *
Required
會費 Membership Fee: HK$50 (一次性 One-off)
銀行轉賬/現金存入中國銀行(香港)戶口 012-875-0-040655-8,請將入數紙副本電郵至hkmarfan@gmail.com,請註明申請者姓名。Bank transfer / cash deposit to Bank of China (Hong Kong) account 012-875-0-040655-8, please email a copy of the deposit slip to hkmarfan@gmail.com, and indicate your name. We shall send you receipt via Whatsapp. Thank you!
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