Lung & Prostate Cancer Public Forum 2019 2019年公开讲座肺癌与前列腺癌报名表
Date日期: Saturday 23rd Nov 2019
2019年11月23日,星期六

Time时间: 10am to 12pm ( English Session) <- REGISTRATION FULL
下午2点至下午4点 (Chinese Session 华文时段)

Venue地点: Lifelong Learning Institute 终身学习学院
Level 1 Event Hall 1楼讲堂
11 Eunos Rd 8, Singapore 408601

Directions 方向
3-minutes walk from Paya Lebar MRT 巴耶利峇地铁三分钟走到
Circle Line (CC9), Exit B 地铁环线, B出口
East-West Line (EW8), Exit A 东西线, A出口

Thank you for your interest to attend our public forum.

Please use this form to register for the English or Mandarin session.
I would like to attend the English / Mandarin session on Saturday, 23rd Nov 2019 我想参加英语 / 华语, 2019年11月23日,星期六的公共讲座。 *
English Session (10am to 12pm) <- REGISTRATION FULL
Personal Particulars
NRIC 身份证号码
(Optional) Please provide use the last 4 charactors for your NRIC. Eg 793C from SXXXX793C
Your answer
Salutation 称呼 *
Eg. Dr , Mr, Ms, Mdm, etc
Surname/ Last Name 姓 *
Eg. Tay, Zhou, Bin Rahmad, S/O Murali
Your answer
Name 名 *
Eg. John, Ah Huat
Your answer
Mobile Number 联系电话 *
This would assist us in reminding you via SMS
Your answer
Email Address 电邮地址
This would assist us in reminding you via email
Your answer
Address
Unit Number 门牌
Eg. #04-77, #06-01
Your answer
Residential Address 地址
Eg. 15 Enggor Street
Your answer
Postal Code 邮区号码
Eg. 079716
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 talks & forums, events and programmes 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
Statement of Consent
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 SCS as a member, volunteer, programme participant, beneficiary and/or donor (“Purpose”), including communications on SCS’ activities, programs and services; donation requests; carrying out research, analysis and development activities for SCS’ purposes; and making disclosures required by law or a competent authority. SCS may, for the above Purpose, disclose my personal data to its third party service providers and/or agents, which may be sited outside of Singapore (subject always to requirements under applicable law having been met). If you wish to receive communications on SCS’ activities, programs and services via phone call and/or text message to a phone number or numbers that you have provided to SCS, please TICK the relevant box(es). 我同意让新加坡防癌协会收集、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/或管理我与新加坡防癌协会的会员、志工、节目参与者、受惠人和/或捐助人的关系,这包括对新加坡防癌协会的活动、节目、服务和捐助要求进行沟通、执行调查、分析和开发与新加坡防癌协会有关的活动,同时应法律或主管当局的要求而透露资料。新加坡防癌协会可因以上的需要,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(在符合相应法规的前提下)。
In any event, you agree that SCS may send communications on its activities, programs and services to you via email and/or post. If you do not wish to receive such communications via email and/or post, or if you wish to make changes to consent previously given, you understand that you may opt-out by writing to the “SCS Data Protection Officer” at “Singapore Cancer Society, 15 Enggor Street, #04-01, Realty Centre, Singapore 079716” or to the following email address dataprotection@singaporecancersociety.org.sg .

在任何情况下, 您同意新加坡防癌协会通过电邮和/或信件的方式通知您相关的活动、项目和服务信息。
如果您不愿意通过电邮和/或信件获知这些信息,或者您要修改之前的同意书,您了解可通过以下方式选择不参加:写信至“SCS Data Protection Officer”(地址:Singapore Cancer Society, 15 Enggor Street, #04-01, Realty Centre, Singapore 079716)或发送电邮至dataprotection@singaporecancersociety.org.sg
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