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AMIRA AFRICA MEMBERSHIP FORM
Welcome To Amira Africa! We are excited to have you with us <3! Kindly assist us with the following information thank you!
Name e.g Nelly Beatrice *
Email *
Your Age *
Phone number *
Occupation *
Location *
Baby's Names e.g Brenda Joan *
Baby's Birthday e.g dd/mm/yyyy *
Baby's Name (second baby)
Baby Number Two Birthday
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