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<form method="post">
  <input type="hidden" name="ScreenId" value="1">
  <p class="PageTitle">AIA VITALITY MEMBERSHIP ACTIVATION</p>
  <p class="CompanyName">UBS AG</p>
  <div class="Step">
    <li class="StepOff"><span class="StepOn">1</span></li>
    <li class="StepOff"><span class="StepOff">2</span></li>
    <li class="StepOff"><span class="StepOff">3</span></li>
    <li class="StepEnd"><span class="StepOff">4</span></li>
  </div>
  <br><br>
  <p class="BodyTitle">Please complete all fields for verification</p>
  <div class="group"><label>Staff ID</label><br><input type="text" name="staffId" size="25" maxlength="20"><br><span class="inputmessage" name="staffIdErrorMsg" id="staffId"></span><br></div><br class="resetgroup">
  <div class="group">
    <label>Identity Type</label><br>
    <input type="radio" name="idType" value="1" checked="">
    <label>HKID</label>
    <input type="radio" name="idType" value="2">
    <label>Macau ID</label>
    <input type="radio" name="idType" value="3">
    <label>Passport/ Others</label><br>
    <span class="inputmessage" name="idTypeErrorMsg"></span><br>
  </div>
  <br class="resetgroup">
  <div class="group"><label>HKID/ Macau ID/ Passport/ Others</label><br>
    <input type="text" name="id" size="25" maxlength="20" onblur="upperText(this)"> e.g.: A123456(7), please input A1234567<br>
    <span class="inputmessage" name="hkIdErrorMsg"></span><br>
  </div>
  <br class="resetgroup">
  <div class="group">
    <label>Date of Birth</label><br>
    <input type="text" name="dobYYYY" placeholder="YYYY" size="5" maxlength="4">
    <input type="text" name="dobMM" placeholder="MM" size="3" maxlength="2">
    <input type="text" name="dobDD" placeholder="DD" size="3" maxlength="2">
    <br>
    <span class="inputmessage" name="dobErrorMsg"></span><br>
  </div>
  <br class="resetgroup">
  <div class="group">
    <label>Enter the characters shown on the right</label><br>
    <input type="text" id="captchafield" name="captcha" maxlength="10" size="9">
    <img class="Border" src="jcaptcha?1" id="captcha">
    <img src="pages/images/Refresh.png" style="vertical-align:18px;"
      onclick="img = document.getElementById(&quot;captcha&quot;); if (img.src.substring(img.src.length-1)!=&quot;1&quot;) {p=&quot;1&quot;} else {p=&quot;2&quot;}; img.src = &quot;jcaptcha?&quot;+p;">
    <br>
    <span class="inputmessage" name="captchaErrorMsg"></span><br>
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  <br class="resetgroup">
  <div class="Buttons">
    <input type="button" class="Secondary" value="CLOSE" onclick="exit()">
    <input type="submit" name="submit" value="NEXT" onclick="FormSubmit()">
  </div>
  <div>Note: Please note that you can only hold one AIA Vitality membership. For any additional application received, AIA Vitality reserves the right to make final arrangement.<br><br></div>
  <input name="submit" id="switchLanguage" type="submit" value="SWITCHLANGUAGE" style="display:none" onclick="FormSubmit()">
  <input type="hidden" name="screenLang" value="en">
</form>

Text Content

繁體


AIA VITALITY MEMBERSHIP ACTIVATION

UBS AG

1 2 3 4



Please complete all fields for verification

Staff ID




Identity Type
HKID Macau ID Passport/ Others



HKID/ Macau ID/ Passport/ Others
e.g.: A123456(7), please input A1234567



Date of Birth




Enter the characters shown on the right





Note: Please note that you can only hold one AIA Vitality membership. For any
additional application received, AIA Vitality reserves the right to make final
arrangement.



CONTACT US

2232 8282 (Hong Kong) / 0800 315 (Macau)
About AIA Vitality
hk.vitality@aia.com


IMPORTANT INFORMATION

Terms and Conditions
Privacy Statement
Terms of Use




Copyright © 2018. AIA Group Limited and its subsidiaries or affiliates. All
rights reserved.

"We", "AIA" or "AIA Hong Kong" herein refers to AIA International Limited
(Incorporated in Bermuda with limited liability).