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会员报名表

2013-02-27 11:00  

                        “自然博物馆俱乐部”会员报名表

Application of BMNH Club

 

Name

 

Gender

 

出生年月Date of birth

 

  Nationality

 

所在地(省市)Location

 

ID

 

身体状况

Health condition

 

Organization

 

Duty

 

Profession

 

学历Educational background

 

兴趣爱好Interests

 

特长Special features

 

座驾Vehicle

车型Mode of vehicle

 

驾龄Age of drive

 

曾参加何种社会团体

Public organizations had joined in

 

 

对“自然馆俱乐部”哪些方面的活动感兴趣

Be interested in

which activities of the Museum Club

 

 

 

对“自然馆俱乐部”将来活动内容、工作开展有何意见和建议

Suggestions for the Museum Club

 

联系电话

Telephone or mobile

 

是否愿意通过短信形式接收活动通知

Would like to receive notification through message

愿意Y               不愿意 N

电子信箱Email

(务必常用且有效)

 

其他网络联系工具

QQ

 

备注Note

 

                                                                                                                                         

·注:报名表如实填制完成,请发送至俱乐部工作邮箱:bmnhclub@sina.com

     

会员俱乐部报名表.doc