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Member Registration
(Member Information & Objective Register)
(Member Type) :

(People)

(Business Name Reservation)
(Certificate's request)
(Object):

(Others):
(Please Specify):

(Login Information )

(E-Mail Address) :

amrptconsultant@gmail.com

E-Mail (E-mail
Confirmation ):

amrptconsultant@gmail.com

(Answer) :

Em

(Password) :

(Password

Confirmation) :

(Question) :

*
? (What is your first school

OK

(Private Informatioin)

Name :

Ms.

Amornrat

Surname : Kampitt

/
(Organization Name):

PT

(Gender) :
(Birthday) :
(Occupation) :

(Address):

(Female)

(Male)

14/08/2520
/Gernal Employee
*

88/104

(Building) :

( Floor):

(Room No.):

(Village) :

(Moo) :

/ (Soi): 46

http://eregist.dbd.go.th/Member/faces/member/registration.jsp?action=insert&mode=us... 05-Sep-12

(Road) :
(Province) :

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77

(Postcode)
:

10250

(Mobile /Telephone No):

08

- 99262215

(Fax) :

02

- 6368568

/ (District):
/ (Subdistrict) :

(Card Type Informaiton)

(Card Type) :

(Card No.) :
(Issue Place):

(Issue Date):

(Member Type) :

(Object) :

/Thai Card

3
- 8499
- 00009
- 02
- 6
*
E-Mail Address :

(Question)
:
11/08/2551
(Answer):

:
(Chang

(Type according to the

picture) :

Name :
Y3GHD

/ :

(Register) Organization
(Cancel)
Name :
(Gender) :
(Birthday) :
(Occupation):

(Address):

(Building):
(Room No) :

(Village):

(Moo) :
(Road):
(Province) :
/ (District):
/ (Subdistrict) :
(Postcode):
(Mobile/Telephone
No) :

http://eregist.dbd.go.th/Member/faces/member/registration.jsp?action=insert&mode=us... 05-Sep-12

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(Fax) :

(Card Type):

(Card No):
(Issue Place):

(Issue Date) :

http://eregist.dbd.go.th/Member/faces/member/registration.jsp?action=insert&mode=us... 05-Sep-12