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附件：

= &nb= sp; = 報名ඤ= 0;

&= nbsp;

參加場&= #27425;：第一梯次與࣪= 3;師有約-龐均油畫<= o:p>

&= nbsp;

姓名:_________________ &nb= sp; □先生 □小姐

&= nbsp;

&nbs= p; &= nbsp; □赫聲之友、y17會員 &nbs= p;

&= nbsp;

出生日&= #26399;：______年______月= ;_______日

&= nbsp;

電話:(住家)：= ____--____________ (行動)：_______--________________

&nbs= p;

年齡：&= #9633;10-20 □21-30 □<= span lang=3DEN-US>31-40 □41-50 □<= span lang=3DEN-US>51-60 □61-

&= nbsp;

職業：□工商 □公&= #21209;員 □老師 □學生 □家管 &= #9633;其他__________

住址:____________________________= ______________________________

E-mail:________________________________________________________

&n= bsp; 詳情資訊：www.e-arttv.com= 6597;詢

請於2011/12/30以前回傳報名&= #34920;，信箱：earttv16@gmail.com

(諮詢專&#= 32218;：02-3322-2288#116c黃小姐傳真：02-2321-2456 )

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