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2022年7-9月活動留名表
Wing 姑娘, HOLAM Sir
請確保資料正確, 稍後將有社工／同工聯絡報名者確認報名
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中文性名 (Chinese Name)
*
Your answer
英文性名 (English Name)
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Your answer
性別 (Gender)
*
Choose
男 (Male)
女 (Female)
岀生日期 (Date of Birth)
*
MM
/
DD
/
YYYY
學校 (中文全名)
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Your answer
就讀級別 (
Year of Study)
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Choose
中一 (Form. 1)
中二 (Form. 2)
中三 (Form. 3)
中四 (Form. 4)
中五 (Form. 5)
中六 (Form. 6)
大專 (Tertiary Education)
其他 (Other)
聯絡電話 (Contact Number)
*
Your answer
是否已成為中心會員 (
Membership)
*
是 (Yes)
否 (No)
電郵 (Email Address)
Your answer
Instagram 帳號 (ID)
Your answer
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