會員資料填寫
Member Information Form


*身分證字號:
*Passport No. or ARC No.:
 

*出生年月日:
*Birth Date:
西元 Year 年 Year 月 Month 日 Date

*密碼:
*Password:

*姓名:
*Name:


*性別:
*Gender:

*手機號碼:
*Cell phone No.:


*電子信箱:
*E-mail address:


收據統一編號:
Business Unified Identification Number for Receipt:

收據抬頭:
Title for Receipt:

備註:
Note:


 
I agree to the service regulations, privacy settings and registration notice of Industry-academia Collaboration and University Extension Division   
個資宣告連結 Personal Information Declaration Link