罐空間|防疫實名制預約表單
為響應政府防疫措施,本場所配合政府「COVID19(武漢肺炎)」防疫新生活運動,採行實聯制措施。參觀者請配合填妥表單後,才可入內參觀或是參與課程活動。您的個人資料依據「個人資料保護法之特定目的及個人資料之類別」代號012公共衛生或傳染病防治之特定目的,所蒐集之資料僅保存 28 日,屆期銷毀。罐空間再次感謝您的配合,謝謝。

Due to the increase in the severity of the pandemic, the disease prevention measures have been upgraded: Cans space can only be visited upon reservation.
Those who wish to visit should fill the following appointment form in advance.
We're sorry for any inconvenience.
Thank you for all your assistance.
1.姓名 Full Name *
2.手機號碼 Contact Phone No. *
請確實填妥可聯繫之電話,謝謝。 Please fill in the available phone number. Thanks!
3.電子信箱 E-mail *
請填寫可以聯絡的電子郵件信箱,謝謝。 Please send us your email,so we would contact you immediately.
4.預約日期 Reservation *
週日公休,請勿預約。 ※ 請提前一天預約,預約回覆將於每週一至週六 11:00-19:00 上班時間回覆, 如有造成不便,敬請見諒。
5.預約時段 Reservation *
6.預約人數 Attendance *
※最多可預約4位。
7.請問過去14天是否有發燒/呼吸道症狀? *
Have you had fever, cough, or shortness of breath during the past 14 days? (for those who had taken medications, please answer “Yes”)
8.請問過去14天的旅遊史。 *
若無旅遊史,請填寫「無」,謝謝! Have you ever been abroad or high-risk area in the last 14 days ? If not,please answer"NO".
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