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澳門復康會會員報名表
本會會員分為功能會員及一般會員
功能會員：從事醫療專業或復康工作之相關人士
一般會員：澳門居民或澳門居住，承認本會章程之人士
填妥報名表後，本會將進行會議分類該會員為功能會員或一般會員
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* Indicates required question
中文姓名 Name (Chinese)
*
Your answer
英文姓名 Name (English)
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Your answer
性別 Sex
*
男 Male
女 Female
出生日期 Date of birth
*
MM
/
DD
/
YYYY
證件類別 Identity type
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澳門居民身分證 BIR
Other:
證件號碼 Identity no.
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Your answer
手提電話或聯絡電話 Mobile / Contact No.
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Your answer
通訊地址 Address
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Your answer
電郵地址 Email
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Your answer
學歷 Education
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小學或以下
中學
大專
大學或以上
Other:
畢業院校 Graduate institutions
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Your answer
畢業科目 Subject
*
Your answer
現職機構 Occupation
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Your answer
職位 Position
*
Your answer
專業資格 Professional Qualification
*
Your answer
介紹人 Referee (如沒有則略過)
Your answer
* 註：所收集之個人資料只作本會內部行政用途
* Remark : The above personal information is for our internal administrative purposes only.
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