路易莎商品禮券購買填寫表單
聯絡人 *
Your answer
聯絡人手機 *
Your answer
電子信箱(ex:test@gmail.com*
Your answer
購買數量 (本) *
1本=10張,2本=20張 -> 如需購買20張,請填寫2;如需購買100張,請填寫10。
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收件人 *
Your answer
收件人聯絡電話 *
Your answer
郵遞區號3+2碼+收件地址(郵遞區號查詢網址https://ppt.cc/faObpx) *
Your answer
發票是否需要開立統編 *
個人資料蒐集、處理、利用書面同意書
個人資料蒐集、處理、利用書面同意書
Agreement on the Personal Data Collection, processing and using
為遵守個人資料保護法規定,並保障當事人之權利,謹依法告知下列事項:
According to the Personal Data Protection Act, the Company hereby issues its statement of personal data protection and collection agreement to notify you of your responsibilities and rights and solicit your consent to the collection, processing and use of your personal data by the Company.
1. 機關名稱: 路易莎職人咖啡股份有限公司 (以下簡稱”本公司”)
The name of the Company: Louisa coffee(the”Company”)
2. 蒐集目的:為執行路易莎咖啡<販售商品禮券>用途。
Purpose of personal data collection: for Launch Luisa Coffee gift certificate .
3. 個人資料之類別:姓名、電話、地址或其他相關基本資料等。
The type of personal data: Name, telephone or mobile phone number, address and the....。
4. 個人資料利用之期間、地區、對象及方式:對於您提供之個人資料,將於執行路易莎咖啡黑卡專案期間,依個人資料保護法之相關規定使用您的個人資料,不另做其他用途。
The time period, area, target and way of the use of personal information: The personal data provided by you will be used only under the purpose and during the period and place of executing Luisa Coffee gift certificate, and shall be comply with the relevant regulation stipulated in Personal Data Protection Act.
5. 依個人資料保護法第3條規定,當事人可行使以下權利:
(1) 查詢或請求閱覽。
(2) 請求製給複製本。
(3) 請求補充或更正。
(4) 請求停止蒐集、處理及利用。
(5) 請求刪除。
若有上述需求,請與本公司連繫(聯絡資訊: http://www.louisacoffee.com.tw/contact-info)。另依個人資料保護法第14條規定,查詢或請求閱覽個人資料或製給複製本者,本公司得酌收必要成本費用。
According to article 3 of Personal Data Protection Act, you are entitled to exercise the following rights:
a) any inquiry and request for a review of the personal information;
b) any request to make duplications of the personal information;
c) any request to supplement or correct the personal information;
d) any request to discontinue collection, processing or use of personal information; and
e) any request to delete the personal information
Please contact the Company if you have any requirement above mentioned ( contact information: http://www.louisacoffee.com.tw/contact-info)。However, according to article 14 of Personal Data Protection Act, the company may charge the necessary fee to those who make an inquiry or request to review, or make duplications of the personal information.
6. 若未提供正確個人資料,本公司將無法提供您蒐集目的範圍內之相關服務。
If you disagree to provide your correct personal information, the Company will be unable to provide you the relevant service within the collection purpose above mentioned.

本人已充分知悉上述告知事項,並同意貴公司基於上述蒐集目的蒐集、處理、利用本人之個人資料。
I have fully read, understood and accepted the contents of this Agreement, and agree the Company to collect, process and use my personal information based on the collection purpose above mentioned.

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