JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
10/16 2021 Delinquente 捌加玖新品品酒
親愛的酒友您好~
感謝您報名 2021/10/16 Delinquente 捌加玖新品品酒會，需要占用您一分鐘的時間幫我們填寫以下表單，活動一週前會將確認信寄至您的信箱中，收到確認信後報名才算完成，請您特別留意，謝謝您。
蓓朵思葡萄酒上
Sign in to Google
to save your progress.
Learn more
* Indicates required question
您的姓名
*
Your answer
您的手機
*
Your answer
您的E-Mail
*
Your answer
報名人數
*
1
2
3
4
5
Other:
∥ 匯款資訊 ∥
提醒您，我們是依匯款順序做為報名的優先順序，建議您先匯款，以確保名額哦！
∥ 匯款資訊 ∥
銀行：013國泰世華銀行 埔墘分行
帳號：043-03-500242-2
戶名：蓓朵思有限公司
您的匯款帳戶後五碼
*
Your answer
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
