Formulario Inscripción Curso LIADA de Formación Contínua

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astrofisica

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astrofisica

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Lugar y fecha

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Lugar y fecha

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Nombres y apellidos

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Nombres y apellidos

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Domicilio

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Domicilio

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Pueblo y/o Ciudad y País

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Pueblo y/o Ciudad y País

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Fecha de nacimiento

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Fecha de nacimiento

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Documento de Identidad No.

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Documento de Identidad No.

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Pertenece a alguna asociación de astronomía

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Pertenece a alguna asociación de astronomía

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Posee instrumentos astronómicos? Descríbalos.

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Posee instrumentos astronómicos? Descríbalos.

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Estudios. Profesión. Oficio

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Estudios. Profesión. Oficio

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Otros datos de interés

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Otros datos de interés

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E-mail

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E-mail

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astrofisica

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Lugar y fecha

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Nombres y apellidos

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Domicilio

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Pueblo y/o Ciudad y País

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Fecha de nacimiento

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Documento de Identidad No.

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Pertenece a alguna asociación de astronomía

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Posee instrumentos astronómicos? Descríbalos.

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Estudios. Profesión. Oficio

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Otros datos de interés

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E-mail

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