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1121007讀史班 報名表
登記資格:
(1) 個人會員(已繳112年度常年會費)
(2) 贊助會員(本場次贊助300元以上)
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Email
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姓名
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性別
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女
登記資格 (學會將協助您取得以下資格)
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個人會員(已繳112年度常年會費)
贊助會員(本場次贊助300元以上)
聯絡電話
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e-mail (為避免沒有收到相關聯絡信件,強烈建議提供gmail。填寫後,請務必再次確認 email 的正確性。)
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公司/職銜,學生請填<學校/系級>
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為方便連絡,您有熟悉的圓覺學會理事嗎?
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由學會指派
王冠翔
余佳蓉
林達志
紀曉芳
范碧儒
張家禎
陳盈瑄
童裕森
謝易霖
備註 (若有其他問題歡迎留言,若非本人填寫,請註明代填者姓名。)
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