_{HSBC Life Member Get Member Promotion – Referee Registration}

Fill in the following to register as a referee for the HSBC Life Member Get Member Promotion. This registration form is applicable for referee who has applied for online insurance plan(s) only.

Fields marked with * are mandatory.

Your policy's information

Policy name*

Policy number* (8-digit number)

Your full name*

Your relationship with referrer

Your referrer’s policy’s information

Referrer’s full name*

Referrer's policy number* (8-digit number)

I have made my own decision to apply for insurance product(s) from HSBC Life (International) Limited (“HSBC Life”) which may be suit my needs. My Referrer has not been involved in any way in my decision to purchase any insurance products and has not given me any advice, suggestions or recommendations in relation to such products.

I have read and agreed to the terms and conditions to this promotion. I have obtained the above individual’s consent to be my Referrer in Life Insurance Member Get Member Promotion. I further confirm that I have notified the Referrer that the full name and the life insurance policy number of the Referrer will be used to fulfil the requirements for participating in the promotion and for administrative purposes (which include my disclosure of such information to HSBC Life and The Hongkong and Shanghai Banking Corporation Limited so they can verify the identity of the Referrer and hence eligibility for the promotion).

View Terms and Conditions.

_{Important notes}

_{The selected life insurance plans mentioned above are underwritten by HSBC Life (International) Limited (“HSBC Life”) and are only intended for sale through The Hongkong and Shanghai Banking Corporation Limited (“HSBC”) in the Hong Kong SAR. HSBC Life is authorised by the Insurance Authority of the Hong Kong SAR to carry on long-term insurance business in the Hong Kong SAR and policyholders are subject to its credit risk. HSBC Life is incorporated in Bermuda with limited liability, and is one of HSBC Group’s insurance underwriting subsidiaries. HSBC is an insurance agent of HSBC Life. Please refer to the respective product brochure for detailed features of the plans and the policy provisions for detailed terms and conditions.}

_{Any person who is interested in buying insurance should discuss with licensed insurance staff (licensed insurance intermediary) regarding insurance or any insurance product features; and no reliance should be placed on any customer or person who is not a licensed insurance intermediary.}

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