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Hong Kong College of Health Service Executives
Membership Application Form - for Associate Fellowship New Member only
*Qualification for Associate Fellowship : holding a degree in management or a full time managerial position
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Title
*
Prof
Dr
Mr
Ms
Mrs
Surname
*
Your answer
Given Name
*
Your answer
Chinese Name
*
Your answer
Gender
*
Male
Female
Professional Qualification
*
Your answer
Qualification in Healthcare Management
*
Your answer
Work Position Held
*
Your answer
Place of Work (Organization/Institution and Department/Division)
*
Your answer
Nature of Organization
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HA
Govt
Private Hospital
Academic Institute
Other Public Organization
Commercial Organization
Corresponding Address
*
Your answer
Contact Number (Office)
Your answer
Mobile Number
*
Your answer
Email
*
Your answer
Date of filling the form
*
MM
/
DD
/
YYYY
I do not consent the College to use my personal data in the HKCHSE WhatsApp group “HKCHSE Members Group”
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