Fiche Membre
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ﺹـرة
أﻥ ا أﺱـ , : ……...........................................................................................................
Mr, Mlle
ا ـ! )ة( ...............................................................................……………………….... : Date et lieu de naissance : ……......................................................……………....... ﺕ ری) و ﻡ' ن ا/زدی د .............................................................................................................. : N° CIN : ….....................................................................…………………………... ر 2ا 1ا....................................................................................................... : 0 Spécialiser : ................................................................................................................. ............................................................................................................. : ا34ـ5 Profession : ................................................................................................................... .............................................................................................................. : ا6ـ Adresse : ................................................................................................................................ .............................................................................................................. : اان Ville : ............................................................................................................................. ا!یـ .............................................................................................................. : Tél. : ......................................................................................................................... ا 6ﺕـ.............................................................................................................. : 7 E-mail : .......................................................................................................................... ا ی! ا'8وﻥ ............................................................................................................ : * N° : .......................................................................................................................... .............................................................................................................. : اـ* 2
أﺕ!م 1ه;ا !3ا/ﻥ4ـاط ? ﺝ'ـ 2اة وأﺕ= !6ام ﻥﻥ 6ا ﺱ ﺱـ. ﺕــ: ا CDوا'یB
اGH8م وااﺹE
ا و وا BH CDاEI
ا :*2ﺥ ص ' Lا8داري.
ا ا ا وا
ا ا? J
أﻥ ا أﺱـ , : ……...........................................................................................................
Mr, Mlle
ا ـ! )ة( ...............................................................................……………………….... : Date et lieu de naissance : ……......................................................……………....... ﺕ ری) و ﻡ' ن ا/زدی د .............................................................................................................. : N° CIN : ….....................................................................…………………………... ر 2ا 1ا....................................................................................................... : 0 Spécialiser : ................................................................................................................. ............................................................................................................. : ا34ـ5 Profession : ................................................................................................................... .............................................................................................................. : ا6ـ Adresse : ................................................................................................................................ .............................................................................................................. : اان Ville : ............................................................................................................................. ا!یـ .............................................................................................................. : Tél. : ......................................................................................................................... ا 6ﺕـ.............................................................................................................. : 7 E-mail : .......................................................................................................................... ا ی! ا'8وﻥ ............................................................................................................ : * N° : .......................................................................................................................... .............................................................................................................. : اـ* 2
أﺕ!م 1ه;ا !3ا/ﻥ4ـاط ? ﺝ'ـ 2اة وأﺕ= !6ام ﻥﻥ 6ا ﺱ ﺱـ. ﺕــ: ا CDوا'یB
اGH8م وااﺹE
ا و وا BH CDاEI
ا :*2ﺥ ص ' Lا8داري.
ا ا ا وا
ا ا? J
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