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INSCRIPCIÓ ESCOLETA
FORMULARI D'INSCRIPCIÓ A ESCOLETA
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NOM I COGNOMS
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DNI
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NÚMERO DE TARGETA SANITÀRIA TSI
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SEXE
DONA
HOME
NO VULL PRECISAR
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NACIONALITAT
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DATA DE NAIXEMENT
MM
/
DD
/
YYYY
LLOC DE NAIXEMENT
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DOMICILI
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POBLACIÓ
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CODI POSTAL
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TELÈFON FIX
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TELÈFON MÒBIL
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MAIL DE CONTACTE
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DADES BANCÀRIES (IBAN)
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