Account Credentials

Full Name *

Login Email *

Password *

Confirm Password *

1. Service User Personal Information

Service User Name *

Nationality

Gender *

MaleFemale

Date of Birth (DD/MM/YYYY) *

Occupation

Mobile Number

Residential Number

Email Address

Education Level

Service User's Address (English)

Current Service Status *

Currently receiving services (e.g., Gov / NGO)Waiting for servicesNot receiving any services

3. Personal Data Collection & Declaration

The collection of your personal data is voluntary. However, data is required to process your service application and maintain service records.

Progress data collected through assessments and training within the Centre may be shared internally with academic researchers affiliated with the Centre / University for bona fide research purposes only.

You have the right to access and correct your personal data. Please contact the Centre Manager or Ms. xxxxxxxx at Phone: 2948-8383 or Email: iwell@eduhk.hk.

I am willing to receive Centre updates, news, social service invitations, and activity notifications.(Optional)I have received, read, and fully understood the 'Notice'. I agree to abide by all the rules and guidelines stated above.*

Applicant's Signature (type full name) *

Date

Case Registration Form

Account Credentials

1. Service User Personal Information

3. Personal Data Collection & Declaration