Gastric Cancer Public Forum 2016 胃癌公开讲座报名表 2016
Thank you for your interest to attend our public forum. Please use this form to register for the English or Mandarin session.

Please note that registration is on a first come, first served basis. You are only allowed to register and attend one session, either the English or Mandarin session.

By completing this form, I consent to allow Singapore Cancer Society (“SCS”) to collect, use, disclose and/or process my personal data in order to process, administer, facilitate, maintain and/or manage my relationship with the organiser as a member, volunteer, programme participant, beneficiary and/or donor (“Purpose”), including communications on our activities, programs and services and donation requests; carrying out research, analysis and development activities for our purposes; and making disclosures required by law or a competent authority. We may disclose my personal data to its third party service providers and/or agents, which may be sited outside of Singapore, for the above Purpose.

谢谢您对新加坡防癌协会公共讲座的兴趣。请用此表格报名。

所有报名会以先到先得方式处理。每人只允许两者任一,只能参加英语或华语的讲座。

提交此表格,表示我同意让新加坡防癌协会(SCS)收集、使用、透露和/或处理我的个人资料,以便处理、执行、促进、保持和/或管理我与主办单位们的会员、志工、节目参与者、受惠人和/或捐助人的关系,这包括对主办单位们的活动、节目、服务和捐助要求进行沟通、执行调查、分析和开发与主办单位们会有关的活动,同时应法律或主管当局的要求而透露资料。主办单位们可因以上的需要,向可能在新加坡境外的第三方服务供应商和/或代理商透露我的个人资料。

* Due to overwhelming response, registration for the English session is now closed. Please call 6421 5860 to be on the waiting list. Alternatively, the Mandarin session is still open for registration. Thank You.

I would like to attend the English / Mandarin session on Saturday, 13th August 2016 我想参加英语 / 华语, 八月十三号的公开讲座。 *
Personal Particulars
NRIC 身份证号码 *
Your answer
Salutation 称呼 *
Your answer
Surname/ Last Name 姓 *
Your answer
Name 名 *
Your answer
Mobile Number 联系电话 *
Your answer
Email Address 电邮地址
Your answer
Residential Address 地址
Your answer
Postal Code 邮区号码
Your answer
Gender 性别
My Race is 我的种族是
My age group is 我的年龄是
I learnt about this public forum from 我通过以下途径获知讲座 *
Required
Is this your first time attending a cancer talk organised by Singapore Cancer Society? 这是您第一次参加由新加坡防癌协会主办的癌症讲座吗?
I would like to be kept informed on future cancer forums, talks and events by SCS 我愿意获知新加坡防癌协会未来的讲座以及活动详情
I would like to be informed through: 我想通过此通道得知详情:
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