1. Registration Form
Please complete all fields below.
About Performer(s)
Performer(s) Student’s Full Name Nationality Email Address Cell Phone
Number
1 Henidiah Fitriana Indonesia henidiahfitriana@gmail.com 0989794104
2 Dyah Ayu S Indonesia suryaningrum@hotmail.com 0988468068
3 Meidiana Purnamasari, Indonesia
4 Intan Kartika Setyawati Indonesia intan46kartika@gmail.com 0988467898
5 Vera Sylvia Saragi Sitio Indonesia vera.tioe89@gmail.com. 0988467887
6 Lina Asmara Wati Indonesia freedom_asmara@yahoo.co.id 0988468024
7 Andri Praja Satria Indonesia
8 Novia Nur Rosyida Indonesia
9 Rhytia Ayu Christianty Putri Indonesia
10 Jessica Renata Yoewono Indonesia punyakare@yahoo.com 0972859940
11 Rista Anggriani Indonesia anggriani_riesta@yahoo.com 0972859944
12 Adelya Kurniawati Desi Indonesia adelyaeffendi@yahoo.com 0975738648
13 Elok Ning Faikoh Indonesia
14 Fenny Indonesia
Name of College/ University
National Pingtung University of Science and Technology
Pick-up Service (Please  )
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2. Tainan Pingtung Kaohsiung
□ Yi-Fong Furniture □ Pingtung Train □ Back Gate of
08:45-08:55 08:30-08:40 Station 09:30-09:40 Kaohsiung Train Station
□ Front Gate of FE21' □ Zuoying HSR station
09:10-09:20 Department Store 10:00-10:10
About Please check the type of your performance: Name of the show:
Performance 1. 舞蹈 Dancing
2. 歌唱 Singing
3. 武術 Martial Art
4. 民俗技藝 Traditional acrobatics Length of the show:
5. 華語相聲 Chinese Cross Talk
± 9 mins
6. 趣味鄉土語 (台語) Taiwanese Talk Show
We would like to acquire your international officer/ coordinator’s signature as confirmation.
Name of international officer/ coordinator Signature of international officer/ coordinator
To prove your identity, please adhere a photocopy of group representative’s student ID.
正 反
(front) (back)
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