JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
台北市中醫師公會(課程)退費申請表
Sign in to Google
to save your progress.
Learn more
* Indicates required question
退費標準
1.本會系列課程因故未能如期開課，本會全額退費，或費用亦可轉換為其他課程費用。
2.繳款人因個人因素申請退費 ，一律酌收行政手續費200元。
姓名
*
Your answer
手機
*
Your answer
課程名稱
*
Your answer
原繳費金額
*
Your answer
退款金額
*
Your answer
銀行名稱
*
Your answer
分行名稱
*
Your answer
銀行戶名
*
Your answer
銀行代號
*
Your answer
銀行帳號
*
Your answer
E-mail
*
Your answer
退款原因
*
課程因故未開成
個人因素，扣行政手續費200元
重複或溢繳繳費，扣行政手續費100元
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
Forms
