LEILU pre-registration
Welcome to LEILU. This is a pre-registration form for you to join the activities of LEILU. Please fill out the form, and our team will contact you soon to exchange more information concerning LEILU participation. Should you have any concerns or questions, feel free to contact leilu.lux@gmail.com.
First name *
Your answer
Last name *
Your answer
Date of birth *
Gender *
Address *
Your answer
Email address (If you don't have an email address, you can provide one of your friends' address) *
Your answer
Telephone/Cell phone number (If you don't have a phone number, you can provide one of your friends' number) *
Your answer
In what language would you like to be contacted? *
How can you describe your current status? *
Which of the following applications do you use?
What is your Facebook account, if you have one?
Your answer
Do you have any comments for us?
Your answer
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