11/1「角聲福音茶座」報名表
Sign in to Google to save your progress. Learn more
英文姓名  English Name (First, Last)  *
中文姓名 Chinese Name
手機號碼 Cell phone number *
請連續輸入數字，無需使用 "( )"  " - " 等符號
電子郵箱 E-mail *
若無 E-mail 請寫 "no"
如果您是癌友或癌友家屬，請問癌症的類型是： 
If you are a cancer patient / survivor or a family member of a cancer patient / survivor, please indicate the cancer diagnosis of the patient
如果有親友陪同，請在以下提供他們的姓名：
Please provide the names of friends or relatives who are coming with you:
您所使用的語言  
Languages that you speak
 *
您如何得知此次活動訊息 (可複選)？
How did you hear about this event
 *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Chinese Christian Herald Crusades.

Does this form look suspicious? Report

Google Forms