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FPA Jockey Club Teen Bean Mobile Classroom Member Application

Please complete the form below

* Mandatory Fields

* Please input Name
* Please select Gender
* Please input Correspondence Address
* Please input a valid Correspondence Address
* Please input Mobile/Contact Telephone No.
* Please input a valid Mobile/Contact Telephone No.
* Please input a valid Email
* Please input a valid Email
* Please select I would like to get my membership card

The Collection and Use of Personal Data Statement

Personal data collected by The Family Planning Association of Hong Kong (FPAHK) will be used for member identification, member application process and communication purpose. Apart from the above usage, all personal data will be kept confidential, handled strictly in accordance with applicable laws and will not be transferred to any organizations or parties.

Please tick the appropriate boxes below if you agree.

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