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中文
Register for TCMAC Member
Registration requirements:
• Registered with the local governing body
• or current student (need proof)
Username 用戶名
First Name 名
Middle Name 中間名
Last Name 姓
E-mail Address 電郵地址
Password 密碼
Confirm Password 密碼
Birth Date 生日日期
Gender 性別
Male 男
Female 女
Other 其他
CTCMPAO License Number 執照號碼
Phone Number 家用電話
Home Address 地址
City 市
Province 省
ZIP/Postal Code 郵政編碼
Clinic Name 診所
Business Phone 工作電話
Business Address 工作地址
City 市
Province 省
ZIP/Postal Code 郵政編碼
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