King's College Old Boys' Association

Objectives of Medical Chapter

To foster better networking and communications among old boys working in medical & healthcare field.
To make available a contact database to facilitate access by other KCOBA members who wish to engage the services of old boys in the medical and healthcare profession.
To set up mentorship program to provide guidance to current students interested to enter medical and healthcare profession and old boys studying in medical and healthcare related undergraduate course.

Section I (Personal Information)

Title

Surname

Given Name

姓

名

Year of Entry

Form

Year of Leaving

Form

Mobile

Telephone (Home)

For Undergraduates

Bachelors

Year

University studying

Section II Occupation / Studying Details

Occupation

Practice

Practice Details / Others

Specialty

NOTES TO APPLICANTS

Personal Data Policy

The Personal Data collected in this form will be used for application for membership of KCOBA and/or updating the existing information contained in the Membership Directory of KCOBA. Such personal data will be used for those purposes relating to the operation of KCOBA or where permitted by all relevant provisions of the Personal Data (Privacy) Ordinance. Information provided in Section I above will be published in a Membership Directory of KCOBA and such information is restricted to the use of KCOBA and/or existing Members of KCOBA solely for networking purposes. Any person who has submitted this form to the KCOBA may elect to have his/her information excluded from the Membership Directory of KCOBA by providing a request in writing to KCOBA. You have the right to request access to and correction of your Personal Data. Any such request shall be made to KCOBA directly.

I agree to allow KCOBA to publish and/or disclose my name and the information contained in Section II above in the Medical Healthcare Directory for KCOBA members who wish to engage my service

Life / Ordinary Member Registration

Title

First Name

Last Name

中文名

Year of Graduation

Form

Occupation

Referral 1

Referral 2

Address (Residential)

Address (Correspondence)

Mobile

Telephone (Home)

Fax (Home)

Telephone (Office)

Fax (Office)

NOTES TO APPLICANTS

Personal Data Policy

Your personal data may only be used for those purposes relating to the running of the Association or where permitted by all relevant provisions of the Personal Data (Privacy) Ordinance. For enquiries in respect of the use of your personal data, please contact KCOBA directly.

Title

Surname

Given Name

中文姓名

Year of Entry

Form

Year of Leaving

Form

Address (Residential)

Mobile

Telephone (Home)

Data Collection Policy

NOTES TO APPLICANTS

Personal Data Policy

I hereby declare that I shall abide by the Constitution and any rules of the Association

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Section I (Personal Information)

For Undergraduates

Section II Occupation / Studying Details

Life / Ordinary Member Registration

Data Collection Policy