保险中介人资格考试

保險中介人資格考試InsuranceIntermediariesQualifyingExamination【電腦應考模式】報名表(試卷一、二、三及五)【ComputerScreenModeExamination】EnrolmentForm(Paper1,2,3&5)填寫本表格前必須參閱「考試手冊」。(「考試手冊」可於本中心索取或瀏覽)YoushouldreadExaminationHandbookbeforecompletingtheform.(Availableat)試卷ExaminationPaper考試編號ExaminationNo.請選擇一個或多個Pleasechooseoneormore第一選擇(1stChoice)第二選擇(2ndChoice)第三選擇(3rdChoice)F試卷一:保險原理及實務PaperI:Principles&PracticeofInsurance__________________________________________F試卷二:一般保險PaperII:GeneralInsurance__________________________________________F試卷三:長期保險PaperIII:LongTermInsurance__________________________________________F試卷五:投資相連長期保險PaperV:Investment-linkedLongTermInsurance__________________________________________考生資料CandidateParticulars英文姓名(正楷書寫及與身份證或護照上的相同):中文姓名:NameinEnglish:NameinChinese:(BlockLettersandasshownonHKIDCardorPassport)香港身份證或護照號碼:出生日期:性別:Male男HKIDCardorPassportNo.:DateofBirth:／／Sex:Female女日DD月MM年YYYY通訊地址:CorrespondenceAddress:(請用正楷填寫)(InBlockLetter)日間聯絡電話／流動電話／傳呼機:住所電話:DaytimeContactTelephone／MobilePhone／PagerNo:ResidentialTelephoneNo.:電郵地址:傳真號碼:E-mailAddress:FaxNo.:繳費方法(每張試卷港幣一佰五十元正)現時職業:ChoiceofPayment(HK$150/paper)PresentOccupation:F支票或銀行本票Cheque/Cashier’sOrderF保險Insurance支票或本票號碼銀行請註明公司PleaseindicateCompany:Cheque/Cashier’sOrderNo.Bank(抬頭為「職業訓練局」Payableto“VocationalTrainingCouncil”)F銀行Banking請註明銀行PleaseindicateBank:F信用咭/易辦事CreditCard/EPSF現金CashF其他Other(只適用於親身報名人士)(只適用於親身報名人士)請註明Pleaseindicate(ApplicableforEnrolmentinPersononly)(ApplicableforEnrolmentinPersononly):Visa／MasterCardEPS01/2009(1stEdition)(請轉後頁Pleaseturnover)(請勿填寫此欄)(ForOfficialUseOnly)考生編號CandidateNo:C**親臨報名，只需把編號填寫在第一選擇內。如郵寄報名，請填寫三個選擇。**Pleasewritedowntheexam.codeinthefirstchoiceonly,whenenrolatthecounter.Ifmailtoenroll,pleasefill3choices.本人已閱讀及同意有關「考試手冊」內所述的條件，包括將個人資料整理作指定用途。本人謹此聲明以上所提供的資料均屬真實及所附証明文件皆為真確副本。本人明白倘若故意虛報資料或隱瞞重要事實，高峰進修學院考試中心可拒絕承認此次報名。IhavereadandagreetotheconditionssetforthintheExaminationHandbookincludingthecollectionofpersonaldataforthepurposesstated.Ideclarethattheinformationgivenaboveiscorrectandcompletetothebestofmyknowledgeandthatthedocumentsprovidedbymeinconnectionwiththisapplicationaretruecopies.IunderstandthatifIknowinglysupplyfalseinformationorwithholdanymaterialinformation,theExamCentre/PEAKshallhavetherighttodenythisEnrolment.考生簽署:日期:SignatureofCandidate:Date:如有任何查詢:職業訓練局高峰進修學院考試中心香港灣仔活道27號職業訓練局大樓M層電話：29191467,29191468,29191478/電郵地址:[e-mail]辦公時間：星期一至五上午九時至下午八時星期六上午九時至正午十二時星期日及公眾假期休息Enquiriescanbedirectedto:PEAKExaminationCentreVocationalTrainingCouncilM/F,VTCTower,27WoodRoad,Wanchai,HongKongTel:29191467,29191468,29191478/E-mailAddress:[e-mail]:9:00a.m.–8:00p.m.(MondaytoFriday)9:00a.m.–12:00noon(Saturday)ClosedonSundaysandPublicHolidays請貼上閣下的香港身份證／護照（附照片一頁）副本《請參閱「考試手冊」第四及第六項》PleaseattachacopyofyourHKIDCard/Passport(apagewithphoto)here(PleaserefertoItems4&6ofExaminationHandbook)NOTESONPERSONALINFORMATIONCOLLECTIONinConnectionwiththeInsuranceIntermediariesQualifyingExaminationWiththecomingintoforceofPersonalData(Privacy)Ordinanceon20December1996,theseNotesarepreparedtoassistyouinunderstandingyourrightsandobligationsinrelationtothesupplyofpersonaldatabyyoutotheVocationalTrainingCouncil(VTC)andthemannerinwhichVTCmayuseordealwithsuchdatainconnectionwiththeInsuranceIntermediariesQualifyingExaminationandothermatters.YouarestronglyadvisedtoreadtheseNotescarefullybeforeyousigntheConsentatthefootthereof.1VTCmaytransferortransmitthepersonaldataofthosecandidateswhohavepassedtheInsuranceIntermediariesQualifyingExaminationorhavebeenfoundcheatinginwhatevermannerinrespectoftheExaminationtotheInsuranceAuthority(IA),InsuranceAgentsRegistrationBoard(IARB),TheHongKongConfederationofInsuranceBrokers(CIB)andProfessionalInsuranceBrokersAssociationLimited(PIBA).Thepersonaldatasotransferredortransmittedmaybeusedbythesebodiesformonitoringpurposeandthepurposesofassistingthemtoperformanddischargetheirfunctions.2YouareentitledunderthePersonalData(Privacy)Ordinancetorequestaccesstoortorequestthecorrectionofanydatasuppliedbyyou,inthemannerandsubjecttothelimitationsprescribedtherein.AllenquiriesshouldbedirectedtoVTC.I,theundersigned,herebyconfirmandacknowledgethatIhavereadandunderstoodtheaboveNotesbeforefurnishingmypersonaldatatoVTC.Ivoluntarilyconsenttotheuseofsuchdata(includingtheHKIDCardno.orpassportno.)andallpersonaldataIpreviouslysupplied,ifany,bytheIA,IARB,CIBandPIBAforthepurposesofdischargingalloranyoftheirfunctionsdescribedinthesaidNotesandforanyotherpurposesdirectlyrelatedtothosepurposes.Date:SignatureofCandidate:保險中介人資格考試個人資料收集說明《個人資料（私隱）條例》已於一九九六年十二月二十日實施，以下內容闡釋考生向職業訓練局提供個人資料時的權利和責任，以及該局在「保險中介人資格考試」或有關事宜上，如何運用及處理個人資料。考生簽署下方的同意書前，必須詳閱本說明。1職業訓練局可將「保險中介人資格考試」中取得及格成績或作弊的考生的個人資料，移交或傳送至保險業監理處、保險代理登記委員會、香港保險顧問聯會及香港專業保險經紀協會。該等機構從移交或傳送途徑取得的考生個人資料，會用於監察事宜或用作協助本身履行有關職責。2根據《個人資料（私隱）條例》，考生有權查閱及更正其提供的個人資料，惟須符合條例所定的方法和限制。查詢可致函或致電主考機構。本人謹此聲明，本人向職業訓練局提供個人資料前，已閱悉及明白本說明的內容。本人自願同意，保險業監理處、保險代理登記委員會、香港保險顧問聯會、香港專業保險經紀協會在履行本說明所述職責或其他直接有關的職責時，可使用本人現時或以往提供的一切資料(包括香港身份證及護照號碼）。日期:考生簽署: