留学保险投保书（7页）.pdf

请以英文正楷填写及在适当方格内加“
”号。

任何答案如有更改，请投保人在旁签署。

Please complete in English BLOCK LETTERS and tick 

the box where appropriate. Any changes to be 

made should be signed by the Proposer.

投保人必须年满18 岁。如受保人为18 岁以下，投保人必须为18 岁或以上并为受保人之父母或合法监护人。The Proposer must be aged 18 or above. For

Insured Person under 18 years old, the Proposer 

should be a parent or legal guardian aged 18 or above.

投保人资料 Details of Proposer

1. 英文姓名#

English Name (请先填写姓氏Surname first) 

2.中文姓名#

Chinese Name 

3.性别#

Gender

□ 男 Male □ 女Female

4.香港身份证号码#

HK ID Card No

5.护照号码#

Passport No

(非香港居民适用 Applicable for n on-HK resident)

6.国籍#

Nationality

(国家/ 地区Country/ Region)

7.出生日期#

Date of Birth

日DD/ 月MM/ 年YYYY

8.通讯地址#

Correspondence Address

室Room/ 号Flat ________ 楼Floor ________ 座Block ________大厦名称/ 期Building/ Phase________