I-CARE GROUP PLAN BASIC INFORMATION SHEET
Kindly fill up the following in order for us to get some basic information about you company/organization. Items with red arrow are required fields.
NAME OF COMPANY
ADDRESS
Tel. No.
Mobile phone number
NATURE OF BUSINESS
CONTACT PERSON
POSITION
E-mail address
NUMBER OF EMPLOYEES
PRESENT HMO ('none' if none)
EXPIRY