Registration Form 報名表

Step 1: Register Information 報名資訊
Step 2: Accompany Person (If there is no accompany person, please skip this step.) 隨行人員(如沒有隨行人員，即可略過此步驟)
Step 3: Category 身份別
Step 4: Registration Fees/Social Programs 報名費/晚宴
Step 5: Method of Payment 付款方式
Registration No. This is a new Registration
* E-Mail
電子郵件
(E-mail is your ID, please keep it! 電子郵件為您的ID，敬請務必保留))
* Password
密碼
Password (6~12 characters, case sensitive) 6~12英數字元，區分大小寫
* Confirmed Password
請再輸入一次密碼
(please type it again 請再輸入一次密碼)
* First Name 名
(Please fill in ENGLISH 建議以英文輸入相關個人資料)
* Last Name 姓
(Please fill in ENGLISH 建議以英文輸入相關個人資料)
* Title 職稱
* Gender 性別
* Institution/Organisation 單位
Postal Address 地址
Post Code 郵遞區號
City 市(無則免填)
State 區域
* Country 國家
* Tel 電話號碼 ex:(+886)-7-285-0878
Fax 傳真號碼 ex:(+886)-7-287-3590

Copyright Registration and Abstract Submission System.
3rd Taiwan Autumn Laryngology Conference (TALC 2025) All right reserved.