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112年度傑出會員選拔連署推薦
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Email
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推薦人
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連署人姓名(三人，可包含推薦人自己，必填)
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候選人姓名
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候選人服務單位
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候選人期別
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候選人經歷
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候選人優良具體事蹟
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候選人聯絡方式(email/電話)
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