S22申请 | DDKonto

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Care Concept S22申请

넳 넲

个人信息/Persönliche Angaben

*请按护照上填写

其他信息/Sonstiges

如果需要递签，请选择拟入境日期 *

保险开始日期 *

Please check and confirm the following terms to finalize your application.

*

ꀐ ꀉ

I hereby affirm and certify that the above statements are true and correct to the best of my knowledge. I understand that a false statement may disqualify me for benefits.

必填字段

*

ꀐ ꀉ

I want to receive news and advertisement from DDKonto by Email. I am aware that I can revoke my consent at any time.

必填字段

*

ꀐ ꀉ

I confirm that I authorize DDKonto to handle my Care Concept insurance.

必填字段

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