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性別 <input type="radio" name="user_gender" value="1" >男 <input type="radio" name="user_gender" value="0" checked="checked" >女<br><br>
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手機:
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家用電話:<br>
<input type="text" name="user_area" maxlength="3" required="" validationmessage="必填!!" autocomplete="off" placeholder="區碼" pattern="[0-9]{2,}" data-pattern-msg="請輸入市話區碼" class="ui-input-text ui-body-c ui-corner-all" style="width:40px; float:left" value=""> <input type="text" name="user_phone" maxlength="15" required="" validationmessage="必填!!" autocomplete="off" placeholder="" pattern="[0-9\-#]{6,}" data-pattern-msg="" class="ui-input-text ui-body-c ui-corner-all" style="width:200px; float:left; margin-left:10px" value="">
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<div class="" style=" line-height:30px"> 聯繫地址 <br>
<select data-role="none" class="ui-input-text ui-body-c ui-corner-all" style="width: 138px; height: 30px; font-size: 16px;" name="add1" id="add1"><option selected value="0">請選擇</option><option value="1">臺北市</option><option value="2">基隆市</option><option value="3">新北市</option><option value="4">宜蘭縣</option><option value="5">新竹市</option><option value="6">新竹縣</option><option value="7">桃園縣</option><option value="8">苗栗縣</option><option value="9">臺中市</option><option value="10">彰化縣</option><option value="11">南投縣</option><option value="12">嘉義市</option><option value="13">嘉義縣</option><option value="14">雲林縣</option><option value="15">臺南市</option><option value="16">高雄市</option><option value="17">澎湖縣</option><option value="18">屏東縣</option><option value="19">台東縣</option><option value="20">花蓮縣</option><option value="21">金門縣</option><option value="22">連江縣</option><option value="23">海南諸島</option><option value="24">其它地區</option></select>
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【會員服務條款】
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服務範圍
第一條 今日傳媒會員服務內容
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