Mita 米大【會員申請】
姓名 Name *
性別 Gender *
出生日期 Date of Birth *
行動電話 Telephone Number *
電子信箱為『會員帳號』,密碼為『會員密碼』,填寫完成後,請不要主動變更帳號、密碼,未來這組帳號、密碼會通用於【Mita 拉鐵粉】相關優惠活動,若擔心有風險,也敬請填寫一組「非個人重要密碼」為米大專用密碼。若有變更需求,敬請聯絡 相關會員訊息詳見“會員福利”。
Email is the "Account" of the member. And this is the "Password" of the member. Please DO NOT easily modify your "Account" and "Password," only used to "Mita Fans." If needed, please fill exclusive password for Mita's use only; if you'd like to modify the password, please contact More info to "Member's Benefits"
電子信箱 Email *
密碼 Passwords(至少6碼) *
居住城市 Residential City *
個人 Facebook 網址 URL (社團申請核對身份使用 For confirmation to Mita Fans Club) *
您是否同意【Mita拉鐵粉 會員規範】 *
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