Page 16 - CUHK MEDICAL ALUMNI Newsletter Issue 1 Vol 5 2017
P. 16

STAY CONNECTED
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                             Medical Alumni Contact Update Form


        Surname *               :
        Given Name *            :

        Year of Graduation *    :

        Specialty *             :
        (e.g. internal medicine,

        surgery, paediatrics)
        Mobile *                :

        Email *                 :
                                                                                                    * Mandatory
        Providing the following personal information is Optional.

        Tel. No. (Office)         :

        Fax No.                 :
        Correspondence          :
        Address



        Please “” the appropriate box(es)
        If you WISH to receive the CUHK Medical Alumni Newsletter  from the Faculty, please state your preference below.
          e-copy ONLY   hard-copy ONLY    NO

         I do not wish to be contacted by CUHK Faculty of Medicine for direct marketing purposes relating to solicitation of
           donations and/or promotion of activities of the Faculty.

            Personal Information Collection
            The  Faculty  of  Medicine  treats  the  data  provided  by  you  as  strictly  confidential.  The  data  is  for  the  Faculty's  administration  and  communication
            purposes, e.g. Medical Faculty News, activities, giving initiatives, courses and programmes. It will be synchronized with the University's alumni database.
            The Faculty will not disclose any personal information to external bodies unless we have obtained your approval or the Faculty is required to do so by

            law. If you do not wish to receive emails from the Faculty in future, please let us know at medical_alum@med.cuhk.edu.hk



                                                                          Online update:
       Medical Alumni Affairs                                                   alumni.med.cuhk.edu.hk
       Faculty and Planning Office
       Faculty of Medicine
       The Chinese University of Hong Kong

       Room 41026, 2/F, Special Block E                    Please return this form to Faculty and Planning Office,
       Prince of Wales Hospital                            Faculty of Medicine, CUHK by
                                                           Fax:      (852) 2649 0208 or
       Shatin, N.T.
                                                          Email:    medical_alum@med.cuhk.edu.hk
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