Membership Application Form

Interested in being a member of the SilverBlack Card?

If yes then complete the below application form to start receiving the cards exclusive benefits. Once you have submitted the form you will be taken to stage 2 which will contain certain instructions on how to complete your application process.

Stage 1 of 2

PLEASE COMPLETE ALL THE FIELDS SHOWN BELOW

The SilverBlack Card is only available to persons over 21 years of age with a valid Hong Kong address.

Title*
First Name*
Last Name*
Occupation*
Address Line 1*
Address Line 2
District*
Area*
Mobile Number*
Home/Office Number
Email Address*
Gender*
Date of Birth*
Method of Payment*
Method of Collection*
Where did you hear about the card?*
Friend's name/ If other, where was it?
Please tick the box if you have read and agree to the SilverBlack Card Terms and Conditions*
To read the SilverBlack Card Terms and Conditions click HERE.
Affiliate Personal Reference Code
Captcha*
 
* = Required

 

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