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淨社區報名表單
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單位名稱
*
Your answer
單位地址
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Your answer
打掃日期
*
MM
/
DD
/
YYYY
打掃地點
*
Your answer
預計參與人數
*
Your answer
是否願意開放給民眾參與
*
是
否
活動聯絡人名字
*
Your answer
聯絡電話
*
Your answer
Ｅ-mail
*
Your answer
活動訊息來源
*
ＬＤＩ官網/ 臉書/ ＩＧ
媒體/ 報紙/ 電台
曾參與過ＬＤＩ辦理的活動
學校
親友
Other:
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