弘道館會員報名表 (Hiromu Kyudokan Membership Application Form)
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Email *
中文姓名 *
English Name *
國籍 (Nationality) *
身份証號碼 (ID Card No.) *
地址 (Address) *
出生日期 (Date of Birth) *
MM
/
DD
/
YYYY
電話號碼 (Tel. No.)
手提號碼 (Mobile No.) *
性別 (Gender) *
緊急聯絡人 (Urgent Contact Person Name) *
緊急聯絡電話 (Urgent Contact No.) *
關系 (Relationship) *
A copy of your responses will be emailed to the address you provided.
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