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校外教學投保意外險之調查表
本次蒐集個資僅供投保意外險之用，有關人員會善盡保密之責，敬請放心填寫。
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1.學號：
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2.姓名：
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3.性別：
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4.身分證字號：
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5.出生(民國)？年？月？日：
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範例：86年06月10日
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6.聯絡手機：
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7.E-mail:
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