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法時刻:兒童與犬類同伴動物關係團體報名表
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兒童姓名
*
Your answer
性別
*
男
女
家長姓名
*
Your answer
兒童出生日期(年月日)
*
Your answer
年齡
*
Your answer
兒童就讀學校
*
Your answer
狗狗名字
*
Your answer
狗狗年紀
*
Your answer
狗狗性別
*
公
母
Required
狗狗已養育幾年
*
Your answer
接送需求
*
可自己接送
需要接送協助
Required
家長通訊方式
*
電話與手機
Your answer
e-mail
*
Your answer
訊息來源
*
機構轉介
學校老師
學校輔導室
本會網站
其他
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