Licensing Executives Society, LES

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國際技術授權主管總會中華分會個人會員申請表
Licensing Executives Society Chinese Taipei Application Form

有*欄位資料請務必填寫/Blanks with*must be filled out.

*姓名

*Name

*身分證字號/ 或護照號碼

*ID No./Passport No.

*性別 / Gender

男 Male　女 Female

*出生年月日 / Date of Birth

年 Y 月 M 日 D

*會員密碼 / Password

*會員密碼再確認
Confirm Password

*出生地

*Place of Birth

*服務單位

*Company Name

*部門

*Department

*職稱

*Position Title

*電話 / Tel No.

(Office) Ex
(Fax) 　
(Mobile)

*E-mail Address

*聯絡地址

*Contact Address

*戶籍住址

*Registered Permanent Address

*主要經歷 Working Experience (由近至遠排列/Putting chronologically)

*服務公司
*Employer'Name
*職稱
*Position Title
*工作內容
*Duties
*起迄時間
*Period

服務公司
Employer'Name
職稱
Position Title
工作內容
Duties
起迄時間
Period

*最高學歷 Highest Education

*學校
*Institution
*系所
*Department
*起迄時間
*Period

是否同意公開通訊資料(全部或部分)等，以便於未來編輯通訊錄之用。
Contact information contained in address book.

是 Yes　否 No

所有的人事、個人資料都將給予隱私保護，若未獲同意，將不對外公開。
All information will be kept confidential. No disclosure without your consent.

1.Fee：
Registration Fee: NT$1,000Annual Fee: NT$1,000 and USD$58.( LES Chinese Taipei shall pay the dues to LES International as established by the Board of Directors of LES International for membership of LES International and for the maintenance of the International Roster, les Nouvelles, and other publications of LES International. Free for the first year, and then USD$58 per year. )

2. How to pay：
Branch：First Commercial Bank Muh Jah Branch
Address：No.12, Bao Yi Road, Taipei, Taiwan, R.O.C.
Swift Code：FCBKTWTPXXX
Account Name：LES Chinese Taipei
Account Number：16710118524

3. Address：
Graduate Institute of Intellectual Property, National Chengchi University,
NO.64,Sec.2,ZhiNan Rd.,Wenshan District,Taipei City 11605,Taiwan (R.O.C)
Contact: 886-2-29393091ext 89512 Ms. Chu; ext 89508 Ms Chan; ext 89121 Ms Lung
Fax:886-2-2938-7486
E-mail：lesct@mail2000.com.tw
Website：http://www.lesct.org.tw/