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<label for="c_intentionIntro" class="e_title col-sm-2 control-label d_formItemTitle h5 color_normal p_intentionIntroTitle">
                                                姓名：
                    </label>
                    <div   id="cwgeq2o"   class="e_input p_FullName" data-ename="單行文本輸入框">
                        <input id="" name="item_22" data-type="1" data-subType="1"
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                        <div   id="i4maaks"   class="e_unit p_UnitName"></div>
                    </div>
                </div>
                
                
                                                                
                                                
                                <div   id="ysuguc2"   class="e_box form-group p_GenderBox" data-ename="單選信息區">
                    <label for="c_intentionIntro" class="e_title col-sm-2 control-label d_formItemTitle h5 color_normal p_intentionIntroTitle">
                                                性別：
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                                                                        <div data-foreachitem class="e_radio p_sex">
                            <label class="option" for="23">
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                                            </div>
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                        <input id="" name="item_25" class="InputText form-control" maxlength="32" data-type="1"
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                </div>
                
                
                                                                
                                                
                                <div   id="aqge2ke"   class="e_box form-group p_TelephoneBox" data-ename="電話(huà)信息區">
                    <label for="c_intentionIntro" class="e_title col-sm-2 control-label d_formItemTitle h5 color_normal p_intentionIntroTitle">
                                                傳真：
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                    <div   id="ko0gsaw"   class="e_input p_telephone" data-ename="電話(huà)輸入框">
                        <input id="" name="item_26" class="InputText form-control" maxlength="32" data-type="1"
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                                <div   id="uym2imw"   class="e_box form-group p_EmailBox" data-ename="郵箱信息區">
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                                                郵箱：
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                    <div   id="asssgq2"   class="e_input p_email" data-ename="郵箱輸入框">
                        <input id="" name="item_27" class="InputText form-control" maxlength="64" data-type="1"
                            data-subType="5" type="text"  data-required="false"  placeholder="請輸入郵箱" tit="郵箱">
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                                <div data-foreachitem class="e_box form-group p_FullNameBox" data-ename="單行文本信息區">
                    <label for="c_intentionIntro" class="e_title col-sm-2 control-label d_formItemTitle h5 color_normal p_intentionIntroTitle">
                                                地址：
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                    <div   id="4wiwuck"   class="e_input p_FullName" data-ename="單行文本輸入框">
                        <input id="" name="item_28" data-type="1" data-subType="1"
                            class="InputText form-control" type="text"                             data-required="false"   maxlength="255"  placeholder="請輸入地址" tit="地址" />
                        <div   id="ic222y2"   class="e_unit p_UnitName"></div>
                    </div>
                </div>
                
                
                                                                
                                                
                                <div data-foreachitem class="e_box form-group p_FullNameBox" data-ename="單行文本信息區">
                    <label for="c_intentionIntro" class="e_title col-sm-2 control-label d_formItemTitle h5 color_normal p_intentionIntroTitle">
                                                郵編：
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                    <div   id="uywwksa"   class="e_input p_FullName" data-ename="單行文本輸入框">
                        <input id="" name="item_29" data-type="1" data-subType="1"
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                        <div   id="qiseuqy"   class="e_unit p_UnitName"></div>
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                <div   id="2gs20cy"   class="e_box form-group p_CaptchasBox" data-ename="驗證碼">
                    
                    <label for="c_intentionIntro" class="e_title col-sm-2 control-label d_formItemTitle h5 color_normal p_intentionIntroTitle">
                        <span id="qi2220o"   class="e_title d_formItemStar color_error p_intentionIntroStar">*</span>
                        <span id="2gg2wsq"   class="i_captcha"> 驗證碼：</span>                    </label>
                    
                    
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                        <div   id="icqcyea"   class="e_input p_EntryInput" data-ename="驗證碼輸入框">
                            
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                        </div>
                        
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                    <div   id="csgeqmy"   class="e_image p_image" data-ename="驗證碼圖片">
                        <img src="" width="100%" height="100%" alt="驗證碼">
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                <div   id="msec2i2"   class="e_wbox p_CoupWBox">
                    <button type="button" class="btn btn-primary submitPC p_submit" data-ename="提交按鈕">提交</button>
                </div>
                
                            </div>
            
        </form>
    </div>
    
        </div>

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