Membership Checkout

Membership Information

You have selected the Associate membership level.

The price for membership is $550.00 now and then $250.00 per Year.

Account Information

Username

Password

Confirm Password

Email Address

Confirm Email Address

Full Name LEAVE THIS BLANK

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Full Name

English

Chinese

Sex

Date of Birth (optional)

HK ID or Passport No.

Qualifications & year obtained

Council

HK Medical Council

HK Nursing Council

Registration number

Address

Home

Tel

Fax

Office

Tel

Fax

You prefer MAILING ADDRESS to be

Home

Office

Do you prefer to receive news mainly by e-mail?

Yes

Proposer & Seconder

Applicants should name one proposer and one seconder (both of them must be HKPS members) to support their membership application. If it is not possible to obtain the signatures of your proposer and / or seconder, please supply their Email below, and we will contact them for confirmation. Please inform your proposer and seconder before submission

Proposer

Name

Seconder

I do not have a proposer or seconder

For applicants who would like to join the HKPS but do not have a proposer and/ or seconder, please tick the box above. HKPS council members will verify your status and contact you for endorsement/ further action. Please ensure that your contact details (above) are accurate

Pay by Cheque

I enclose a cheque of $550.- (being $300 for entrance fee and $250 for the current year membership fee), payable to the HONG KONG PAEDIATRIC SOCIETY. (Refundable if the application is unsuccessful). (Correct amount for entrance fee & current year membership fee by crossed cheque is an essential pre-requisite for application.) Successful members are assured that their data will be disclosed to outside societies only for relevant academic function and the Medical Diary. Please inform Hon. Secretary in writing if you object to receive these material.

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