中银商务团体医疗保险计划投保书（8页）.pdf
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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（公司）资料 Details of Proposer (Company)
1. 公司名称(英文) Name of Company (English )
2. 公司名称(中文) Name of Company (Chinese)
3. 商业登记号码
Business Registration No.
4. 业务性质
Nature of Business
5. 通讯地址Correspondence Address
室Room/ Flat ________
数Floor ________
座Block/ Tower ________
大厦/屋苑Building/ Estate ____
街道号数及名称Number and Name of Street/Road ___
地区District __
□ 香港HK □ 九龙KLN □ 新界NT
6. 联络资料Contact Information
联络人姓名Name of Contact Person
电话号码Tel No.
传真号码Fax No.
电邮地址Email Address
投保详情 Details of Application
计划选择Plan Option：
保障类别Plan
僱员类别Employee
Classification
I. 基本保障Basic Benefits II. 自选保障Optional Benefits 如提供家属
and tick the box
where appropriate. Any changes to be made
should be signed by the Proposer.
投保人（公司）资料 Details of Proposer (Company)
1. 公司名称(英文) Name of Company (English )
2. 公司名称(中文) Name of Company (Chinese)
3. 商业登记号码
Business Registration No.
4. 业务性质
Nature of Business
5. 通讯地址Correspondence Address
室Room/ Flat ________
数Floor ________
座Block/ Tower ________
大厦/屋苑Building/ Estate ____
街道号数及名称Number and Name of Street/Road ___
地区District __
□ 香港HK □ 九龙KLN □ 新界NT
6. 联络资料Contact Information
联络人姓名Name of Contact Person
电话号码Tel No.
传真号码Fax No.
电邮地址Email Address
投保详情 Details of Application
计划选择Plan Option：
保障类别Plan
僱员类别Employee
Classification
I. 基本保障Basic Benefits II. 自选保障Optional Benefits 如提供家属
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