員工福利委員會--「桃園新屋百年石滬一日遊」活動

(Off-Campus)

* Required

* Name:
* Gender:
*Affiliation/Department: /
* Job Title:
Years of Service: Years Months (E.g. 3 years & 2 months)
*ID/ARC Number:
*Date of birth: 選擇起始日 Quick-change click calendar year or month
* Contact Number.:    Mobile:
Please provide at least one of the following: home telephone, office extension, or mobile phone
Fax:
*Email:
* Meal Option:
午餐:
Shuttle:
上車地點



Driving (license plate number):
Note:
Authentication code: Please enter the exact characters shown in picture below

I have read and agree that the registration system may collect relevant personal information:
  1. In accordance with Article 6 of the Personal Information Protection Act, the registration system provides a Privacy Statement prior to collection of personal information.
  2. Refusal of the Privacy Statement will result in unsuccessful registrations.