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  Membership Form
 

 
Personal Information
 

Name:_________________________________________________________________

Class: ______ No: _____ Age: _____ Mobile No: ____________________

Email: _____________________ @ _______________

Hobbies/ Interests: _________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________ 

Suggestions for the club: ________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________ 

_______________________________________________________________________

Date: ___ /___ /_____                        

                                                     Signature: ________________________________ 

 
                                 
                             Rua Carlos Vieira Ramos | 2774 - 516 Paço de Arcos | Tel: 214425049 | Fax: 214427439
e-mail: info@eslfb.pt | http://eslfb.pt
 
 

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