Member RegistrationTitle*MrMrsMissMsMdmNRIC / FIN*First Name*Last Name / Surname*Email* Enter Email Confirm Email Date of Birth* DD slash MM slash YYYY Address* Street Address City Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Membership number*How did you get to know us?*Ecommerce (Eg.Carousell,Gumtree,Qoo10,etc)FacebookWebsiteInstagramGoogleWalk-inFriends RecommendationNot ApplicableHighlights of membership perks: Membership Privileges (1 year):Free Diagnosis for all Laptops, PCs & Tablets10% off for all repair services (Not valid for direct hardware purchase)Exclusive discounts on Digital Hospital & Dr Geek Service package purchasesBirthday Month Special - Laptop Spa @ $49 inclusive of GST (UP: $129)Free UV & Ozone Sterilization of your phone at any of our outletsFree faulty stripped screw removal serviceFree laptop keycap replacement (subject to availability)You hereby agree that you are applying for the membership of Digital Hospital and its associated brands (namely PC Dreams, Laptop Outlet and Laptop Factory Outlet) and you consent to the collection, storage and processing of your personal data provided in this Form for the purpose of receiving membership updates, news, educational and marketing mails and/or materials from our affiliated partners You hereby give your consent to Digital Hospital and its associated company of brands to store and process your Personal Data; and to disclose your Personal Data to relevant authorities or third parties, where required, by law or for legal purposes.* I agree to the below terms and conditionsYou hereby agree that you are applying for the membership of Digital Hospital and its associated brands (namely PC Dreams, Laptop Outlet and Laptop Factory Outlet) and you consent to the collection, storage and processing of your personal data provided in this Form for the purpose of receiving membership updates, news, educational and marketing mails and/or materials from our affiliated partners You hereby give your consent to Digital Hospital and its associated company of brands to store and process your Personal Data; and to disclose your Personal Data to relevant authorities or third parties, where required, by law or for legal purposes. EmailThis field is for validation purposes and should be left unchanged.Read full member’s privileges @ Membership Terms and Conditions
