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Formulaire pour demande de licence
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Email
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Your email
TYPE DE LICENCE
*
joueur
dirigeant
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NOM
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Your answer
PRENOM
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Your answer
ADRESSE
*
Your answer
NE (E) le
*
Your answer
VILLE DE NAISSANCE
*
Your answer
PAYS DE NAISSANCE
*
Your answer
NATIONALITE
*
Française
Etrangère
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PAYS DE NATIONALITE
*
Your answer
EMAIL
*
Your answer
TELEPHONE
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Your answer
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