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課程退費申請單
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* Indicates required question
1. 課程名稱
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2. 課程編號
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請於活動頁面上查詢
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3. 訂單編號 / 票號
*
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4. 學員姓名
*
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5.銀行戶名
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6. 銀行名稱
*
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7. 銀行分行名稱
*
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銀行帳號
*
最多14碼 (請用 - 符號分隔)
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