個人資料 Personal Information
請用英文大楷填寫 Please write in BLOCK LETTERS
Email address *
會員 Member *
Required
CCCD會員證號碼 CCCD Membership No. (如有 if any)
Your answer
姓名 Name (中文)
Your answer
姓名 Name (English) 將列印於活動證明上 To be printed on Certificate *
Your answer
年齡 Age
Your answer
性別 Sex *
Your answer
職業 Occupation / Promotion Code
Your answer
聯絡電話 Tel *
Your answer
郵寄地址 Mailing Address
Your answer
完成研討日/工作坊後,是否需要活動證明?Request for Certification *
Required
*姓名將列印於活動證書明上,證書郵寄地址將同上,請確保無誤。
*Please carefully check the spelling of your name which will be printed on your certificate. The certificate will be sent according to the address above.
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