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姓名 / 團體名稱 Name of Individual / Organisation
(英)English:  
(中)Chinese:  
會員編號(只供現有會員填寫)
Membership No. (For old members only):
 
團體負責人姓名Person in Charge of Group Member
(英)English: 
(中)Chinese: 
個人 / 團體負責人身份證號碼
ID Card Number of Individual or Person in Charge:
 
聯絡電話Telephone: 
移動電話Mobile Phone: 
傳真 Fax: 
電郵 Email: 
通訊地址Correspondence Address: 
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