Apply for the Safety Alarm Service Registration Form
 
< User information >
Name* :      Male   Female
Home Tel* :    
 
< User information >
Name*      Male   Female
Age* ID No.*  ( )
Home Tel* Mobile
Address*
 
Are you living alone?
 Yes
 No Name of Co-habitant(s) 
Relationship with the Co-habitant(s)        Age  
 
Are you a recipient of CSSA?
 Yes CSSA NO.   C 
 No
Rental    (Monthly service charge costs HK$115)
I hereby agree and authorize Senior Citizen Home Safety Association to provide my information to Social Welfare Department and Housing Society for applying the safety alarm special allowance.
 



 
Copyright © 2014 Hong Kong Safety Services Association Ltd. All Rights Reserved.
24-hour Hotline: 2429 6060
Fax: 2429 9321
Registration hotline: 3906 5655/3973 2623/3906 5662/2920 9651