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2017創新教學與自由軟體研討會報名表
本表提供外縣市朋友參加本次研討會報名用，每縣市提供兩位住宿名額。(本次所收集之個人資料僅限於本次活動使用，活動結束後即刻直接刪除)
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所屬縣市
*
Your answer
所屬單位
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Your answer
姓名
Your answer
電子郵件
*
Your answer
是否住宿?
*
是
否
身分證字號(住宿使用，不住宿免填)
Your answer
聯絡電話(請留行動電話)
*
Your answer
飲食習慣
*
葷
素
Other:
是否需要從宜蘭火車站接駁?
*
是
否，自行開車前來
其他需求與建議
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