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五專完全免試意願調查表
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班級(如:301)
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座號(如:13)
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姓名
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生日(20010406)
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身份證字號
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通訊地址
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通訊電話
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手機
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報名學校
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報名科系
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是否有參加技藝學程
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技藝競賽名次(填寫名次或無)
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