花甲俱樂部 加入申請登記表
※填寫會員申請登記表單後,必須擇日攜帶身份證件,親洽一里雲村櫃台完成入會作業手續
Sign in to Google to save your progress. Learn more
姓名: *
性別: *
出生年月日:(國曆) *
MM
/
DD
/
YYYY
連絡電話: *
居住地區 *
Required
備註
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy