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Fiche de renseignements Famille d'Accueil
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Email
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Informations vous concernant...
Nom :
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Prénom
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Date de naissance
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Adresse
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Code postal
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Ville
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Téléphone
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Situation familiale
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Métier
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Pseudo Facebook
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Possédez vous un permis de conduire
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oui
Non
Other:
Possédez vous un véhicule
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oui
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Other:
Quelle distance acceptez vous de parcourir pour récupérer un animal ?
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Enfants ? Nombre, âges, etc..
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