Adhésion au Club les violettes
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Bulletin d'adhésion au Club les Violettes
Nom *
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Prénom *
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Date de naissance *
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Adresse (exemple : batiment 1)
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N°de voie *
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Libellé de la voie *
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Code postal *
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Ville *
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Téléphone fixe *
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Téléphone mobile
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adresse email *
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Activité(s) souhaitée(s) *
Commentaire
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