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Registracija į Rotary Apygardos 1462 Asamblėją ir PETS
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Vardas Pavardė
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Atstovaujamas klubas
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Rotary
Rotaract
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Atstovaujamo klubo pavadinimas
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Pareigos klube
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Pareigos Apygardoje (jei Apygardos pareigūnas/-ė)
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