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113年丙級獨木舟教練講習報名表
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姓名 *
性別 *
出生年月日(西元) *
MM
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DD
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YYYY
身分證身分證字號 *
最高學歷 *
現任職務 *
手機號 *
通訊地址 *
line ID *
飲食 *
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