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第17屆臺大化工營匯款回條
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姓名
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就讀學校
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匯款戶名（若為無摺存款，請填匯款人姓名)請填「自己」的戶名！！！而非我們提供匯款的戶名！！！
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匯款帳號末五碼（若為無摺存款，請填局號）請確實填「自己」的匯款帳號「末五碼」！！！而非我們提供匯款的帳號！！！
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匯款日期
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匯款時間
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