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DATOS DEL JOVEN EMPRENDEDOR/A
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NOMBRES Y APELLIDOS:
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C.I. Nº:
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FECHA DE NACIMIENTO:
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MM
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DD
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YYYY
EDAD:
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CIUDAD/DEPARTAMENTO:
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DIRECCIÓN:
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CORREO ELECTRÓNICO:
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TELÉFONO DE CONTACTO:
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INCORPORACIÓN A LA ACTIVIDAD AGRARIA:
SI
No
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SI LA RESPUESTA ES "SI", ESPECIFICAR TIEMPO (MESES, AÑOS):
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TIPO DE ACTIVIDAD:
AGRÍCOLA
PECUARIA
FORESTAL
SOCIAL
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