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王母救世宮-土耳其震災集資捐款-回報表單
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* Indicates required question
捐款人-姓名
*
Your answer
捐款金額
*
Your answer
捐款銀行
*
Your answer
帳號末5碼
*
Your answer
收據寄送
*
要寄收據
不寄收據
親赴本宮領取
疏文登錄
登錄祈福超薦之功德主姓名、地址、電話
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地址
*
Your answer
電話
Your answer
email
Your answer
LINE ID
Your answer
捐款人-性別
*
男
女
以下生日(國曆、農曆)擇一填寫。用途-讓神明認識你。
國曆生日
MM
/
DD
/
YYYY
農曆 生日
格式:(農曆) 年 月 日 時 生肖
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