《AXA 安盛馬到功「盛」大抽獎》登記表格
“AXA Year of the Horse Lucky Draw”
Registration form

一經成功登記，系統將自動計算抽獎機會。Number of lucky draw chances will be calculated automatically upon successful registration.

聯絡資料
Contact information

(所有資料須與 AXA 安盛保單紀錄相同 All information must match your AXA policy record.)

姓氏（英文）Surname (in English)*

名（英文）Given name (in English)*

（姓名須與身份證明文件相同作領獎用途。）
(Your name must match your identity document for prize collection purpose.)

電郵地址 Email address*

電郵地址 (再次填寫) Email address (Re-enter)*

手機號碼 Mobile number*

香港身份證號碼字母及首三位數字或有效旅遊證件的字母及首三位數字或首四位數字 Alphabet(s) and the first 3 digits of Hong Kong Identity Card number; or Alphabet(s) and the first 3 digits or first 4 digits of the valid travel document *

（所提供的電郵地址及手機號碼將用於是次抽獎的登記和通訊用途，身份證明文件資料僅用於核實客戶身份。詳情請參閱抽獎條款及細則及《收集個人資料的聲明》）
(Email address and mobile number provided will be used for this lucky draw’s registration and communication purpose. The identity document information will only be used to verify the identity of the customer. For more details, please refer to the Terms and Conditions and the Personal Data Collection Statement for the lucky draw.)

🔍 請檢查您的提交內容 Please Review Your Submission

🔍 請檢查您的提交內容
Please Review Your Submission