“Lifestyle Passport”
Eligibility Registration Form

The “Lifestyle Passport” (“the Privilege”) is only applicable to the first 200 customers who hold a valid designated Hong Kong’s admission scheme visa/entry permit, have successfully insured with a First Year Annualised Premium of HK$500,000 or more on an eligible policy, and completed the "Lifestyle Passport" Eligibility Registration Form. The "Lifestyle Passport" is available in limited quantities. For details, please refer to the Terms and Conditions for the Lifestyle Passport.

Please complete the form below to finish the registration, and ensure that the information provided is accurate and complete, so that we can verify your eligibility and process the Privilege.

Registration Form

*Mandatory field

Gender

Male

Female

Personal Information

First Name (same as your valid HKID/ travel document)

Last Name (same as your valid HKID/ travel document)

Email address

Valid mobile number

12-digit Proposal Number

8-digit Referral Code (mobile number of your financial consultant or representative / staff number of your insurance broker or representative)

Please note that the provision of above personal data is voluntary in nature. By submitting this form, you confirm your understanding of and agreement to: (i) the contents of the above Personal Information Collection Statement; (ii) the Privacy Policy of Prudential; (iii) Prudential's use of your personal information for the purpose of processing the redemption of the "Lifestyle Passport" that is initiated by Prudential and provided by New World Development; (iv) if required, you agree to provide documentation proving your eligibility under the Hong Kong’s admission cheme; (v) you confirm that the information and documents provided are true and correct; (vi) all terms and conditions of the Privilege.

“Lifestyle Passport”Eligibility Registration Form

Registration Form

Gender

Personal Information

“Lifestyle Passport”
Eligibility Registration Form