Application Form

 

Thank you for joining FWD Parents Club. Simply fill in the following details to become a member:

* Mandatory fields
Parents' Information
* Are you an existing customer of FWD? Yes No
* Name (Eng):
Name (Chi):
* Title: Mr. Mrs. Ms.
HKID: ()
Policy Number:
Date of Birth:
Occupation:
Address:
* Email address:
(Please fill in clearly, as the email address will be used for notifying you of activities in the future)
* Telephone: (Mobile) : (Home) :
Spouse Information (If applicable):
Name:
Title: Mr. Mrs. Ms.
HKID: (first letter & first 3 digits)
Children's Information:
No. of children:
(please fill in so your children can join member activities in the future)
Children Information
Name Gender Date of birth Email (if applicable) FWD existing customer
M F Yes No
M F Yes No
M F Yes No
M F Yes No
*How do you know about our Club?
Friends Member’s Name: Member’s Email Address:
FWD Advisers
Website
Others (Please specify):
FWD Adviser Information
Adviser Name:
Adviser Code:
Location Code:

DECLARATION
I have read and understood the above Terms and Conditions and "Personal Information Collection Statement" and agree to be bound by the same.

If you do NOT wish FWD Life Insurance Company (Bermuda) Limited to use Your Personal Data in direct marketing or provide Your Personal Data to other persons or companies for their use in direct marketing, please tick the appropriate box(es) below to exercise your opt-out right.
Please do not send direct marketing information to me.