FREE Eu Yan Sang Membership

1
Name* This field is required.姓名
Mr.
Mr.
Ms.
Mrs.
Mdm.
Dr.
Prefix
First Name
Last Name
2
E-mail* This field is required.电子邮箱
e.g. brucewayne@hotmail.com (Please enter a valid email, as verification is required)
3
Mobile Number* This field is required.手机号码
8 Digit Number
4
Home Number* This field is required.住家号码
8 Digit Number
5
NRIC/FIN Number (Last 4 Digits + Alphabet) * This field is required.身份证/ 护照号码 (最后4位+字母)
Last 4 Digits & Alphabet (e.g. 9876A)
6
Residential Address* This field is required.住家地址
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
7
Birth Date* This field is required.出生日期
Month
Day
Year
8
Do You Have Children Below 12 Years Old?* This field is required.如有孩童的会员家长，请在以下填上孩子的出生年份，以获得相关的促销活动讯息。
YESNO
9
Let Us Know The Year Your Child Is Born让我们知道您的孩子出生年份
Year of Birth/出生年份 e.g. 2014
Year of Birth/出生年份 e.g. 2014
10
Choose Your Preferred Language of Communication首选语言
English 英文
Chinese 中文
11
I would like to receive information and updates from Eu Yan Sang and be contacted via the following mode (s)* This field is required.本人同意通过以下的模式接收任何促销活动有关的讯息
Voice Call 电话联络
SMS 短讯
Email 电子邮箱
12
Please upload a screenshot image of your member profile in Doctor Sinseh mobile app for verification purposes.* This field is required.Tap on 'Account' tab to display your profile.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
13
Submission确认提交
I have read the Terms and Conditions and agreed to Eu Yan Sang (Singapore) to use, process and analyse my personal data for the purpose of providing better customer service, information on promotional offers and membership privileges. 本人已参阅条款与细则，并且同意余仁生国际集团收集，使用本人的个人数据分析，以便提供完善的客户服务，及发送营销，广告和促销的有关讯息
14
Upon submission of your application, you will receive a confirmation email from us with the details of your membership.

提交申请后，您将收到我们发送的确认电子邮件，其中包含您的会员资格

Thank you! 谢谢!
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