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Seminar Registration Form: Senior Caregiver Support【
長者的居家照護
】系列講座
感謝您對中心講座感興趣，請於活動前填寫以下報名表，謝謝！
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What topic do you want to attend? 您想要參加哪些場次? （可複選)
Time: Saturday 10am~12pm， 講座時間：週六上午10點至中午12點
(4/15) - 1. The Senior Source & Caregiver Support長者照護的基本簡介
(5/20) - 2. Caregiving: Where Do I Start長者照護的長遠規劃
(6/17) - 3. Aging in Place: Home Safety長者照護的居家安全
(7/15) - 4. Financial Caregiving長者照護的財務管理
Are you planning to attend the seminar online or in-person? 請問您將現場還是線上參加講座？
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In-Person 現場
Online 線上
First Name 名
*
Your answer
Last Name 姓
*
Your answer
Gender 性別
*
Female
Male
Age 年齡
*
Your answer
Email 電子信箱
*
Your answer
Home Zip Code 郵遞區號
*
Your answer
Phone number 電話
*
Your answer
Why do you want to attend this seminar? 您為何想參加此次講座? （可複選，或填寫其他)
Need to take care for your aging families.家中有長者需要照顧
Want to know more for myself in the furture.自己想多了解這方面資訊
Working or Studying in Medical, Senior, Health care...fileds.從事或就讀健康醫療、長者照護等相關領域
Other:
Where do you know about this event? 您如何知道此次講座？（可複選)
Newsletter 中心電子報
Website 中心網站
Facebook 中心臉書
Google Group
Line/WeChat
Newspaper 報紙
Friends 朋友
Others 其他
Whether or not to receive emails from us? 是否願意收到中心相關信息？
Yes 是
No 否
Clear selection
Comments 其他問題（如果有講座相關問題，可以事先告知，謝謝！）
Your answer
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