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雙塔520x北高360退費表單(個人報名)
請依報名時所報之模式(個人or團體)填寫表單，收至表單以後，每周四進行退款。
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Email
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Your email
姓名
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Your answer
身分證字號
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Your answer
連絡手機
*
Your answer
銀行簡稱 (ex: 郵局)
*
Your answer
銀行代碼 (3碼)
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Your answer
銀行帳號 (請直接填寫數字，不須空格或"-"符號)
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Your answer
備註
Your answer
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