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 the service booking 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.

The Use of Personal Data for Promotional Purpose

FPAHK would like to provide our promotional information to you by email according to the contact information you have provided (including name, email address etc.)

Even if you agree to receive FPAHK promotional information now, you may change your mind in the future. Please notify us of your name and email address through email, we will stop sending any promotional information to you.

For contact information of FPAHK, please visit our website.

Please tick the appropriate boxes below if you agree.

* Please tick the box
* Please input Captcha