Accueil
Formulaire d’adhésion au
GRoW26
Country :
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Civility :
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Monsieur
Madame
Nom * :
Prénom * :
Email :
Numéro de téléphone (WhatsApp conseillé) :
Birth date :
Profession :
Address :
Department :
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ALIBORI (BJ)
ATACORA (BJ)
ATLANTIQUE (BJ)
BORGOU (BJ)
COLLINES (BJ)
COUFFO (BJ)
DONGA (BJ)
LITTORAL (BJ)
MONO (BJ)
OUEME (BJ)
PLATEAU (BJ)
ZOU (BJ)
Commune :
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Arrondissement :
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Neighborhood :
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Influence zone :
Vous provenez de quel mouvement ?
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Aucun (Aucun)
CAEV (Mouvement)
FIDELITE ET LOYAUTE GODOMEY (FELG)
Jeûnes UAC (Jeûnes UAC)
Nip :
Consent :
Je m'engage !
