台灣可威有限公司

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Name：	Male Female
E-mail：
Password：
Confirm Password：
Membership status：	General Membership Distributor， Dealer name ：
	Membership applications for distributor need to be verified.
Mobile：
TEL：

Birthday：	Year Month Day

Address：
Zip code：
Identify Code：	Refresh
Thank you for completing the above information, we will register your membership immediately. If you have any questions, please contact us.