退休人员名录登记

请填写以下资料到退休人员名册登记. 所有必需的字段都有标记 *

个人信息

First Name: *

Last Name: *

Email: *

Spouse/Partner:

Home Phone: *

xxx-xxx-xxxx

Cell Phone: *

xxx-xxx-xxxx

Department:

账户信息

Username: *

Password: *

Confirm Password: *

Permanent Address

Address Line 1: *

Address Line 2:

City: *

State: *

Zip: *

xxxxx

您占用此地址的日期:
开始占用该地址的月份开始占用此地址的日期 until 月底您占用此地址结束日你占用这个地址

Seasonal Address

Address Line 1:

Address Line 2:

City:

State:

Zip:

xxxxx

季节性家庭电话:

xxx-xxx-xxxx

您占用此地址的日期:
从你住进这个地址的那个月开始从你占用这个地址的那天开始 until 月底你占用这个地址结束时你占用这个地址

Other Information

Comments:

目录中应该显示哪些信息?
Home Phone
Cell Phone
Permanent Address
Seasonal Address
季节性家庭电话
Email

报告此页的问题