join member

* Username

* 密碼

* 確認密碼

密碼需超過 10 位，僅允許英數字、底線（_）、減號（-）

* Name

* Birthday

Year 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

Month 1 2 3 4 5 6 7 8 9 10 11 12

Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

* Email ( After registration, if you have not received the email, please check your spam folder or search for "長照學習" )

* ID card or UI No

Contact number

* Mobile

* Contact Address

Are you working in a long-term care institution? Yes No

* Working unit

* job title （If you want to apply for the certificate of care attendant, please select [Student of Care Service Course]） DoctorTraditional Chinese PhysicianDentistPharmacistAssistant Pharmacist Registered NurseLicensed Practical NursePhysiotherapistPhysiotherapist AssistantOccupational TherapistOccupational Therapy AssistantMedical TechnologistMedical Technician Medical Radiation TechnologistMedical Radiological TechnicianDietitianMidwifeMidwife TechnicianPsychologistRespiratory TherapistSpeech TherapistCertified Dental TechnicianAudiologistOptometristOptometrist AssistantSocial WorkerSocial WorkersCare Management SpecialistCare Management SupervisionCare AttendantNursing Service Course StudentsHome Services SupervisorEducational StaffLife AttendantFamily Care AttendantCase ManagerGeneral PublicCertified in Public Health

Whether they are aborigines

 Yes       No

Category of long-term care service personnel（For non-long-term service personnel, please select [unlimited]）