世界留台校友會聯誼總會第12屆會員代表大會暨聯誼大會

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12th Meeting and Gathering World Federation of Taiwan Alumni Association Bali 2024

**海外校友版

Email *

國家 Country : *

姓名 (中文) : *

外文姓名 (與護照姓名相同) Name same as passport : *

性別 Gender : *

男 Male

女 Female

年齡 Age : *

護照號碼 Passport Number ： *

行動電話 Mobile (WhatsApp / LINE) : *

請加入國碼 ex. +62xxxxxxxx

素食 Vegetarian : *

是 Yes

否 No

大會T恤 (款式適中，不分男女)，請選擇您平時穿著尺寸：

Please choose your usual size for T-shirts (unisex) :

XXL

其他 Others

留台校友入學學年(民國) / 畢(肄)業學校名稱及系別：

For Taiwan Alumni : Enrollment year / School name & Department studied

所屬留台校友會/職稱 Join Taiwan Alumni Association / Title :

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