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PERSONAL INFORMATION

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Last name *	First name *
Address Line 1
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Zip code	City	Country * afghanistan albania algeria american samoa andorra angola anguilla antarctica antigua and barbuda argentina armenia aruba asie/pacifique australia austria azerbaijan bahamas bahrain bangladesh barbados belarus belgium belize benin bermuda bhutan bolivia bosnia and herzegovina botswana bouvet island brazil british indian ocean territory brunei darussalam bulgaria burkina faso burundi cambodia cameroon canada cape verde cayman islands central african republic chad chile china christmas island cocos (keeling) islands colombia comoros congo congo, the democratic republic of the cook islands costa rica croatia cuba cyprus czech republic côte d'ivoire denmark djibouti dominica dominican republic ecuador egypt el salvador equatorial guinea eritrea estonia ethiopia falkland islands (malvinas) faroe islands fiji finland france french guiana french polynesia french southern territories gabon gambia georgia germany ghana gibraltar greece greenland grenada guadeloupe guam guatemala guernesey guinea guinea-bissau guyana haiti heard island and mcdonald islands holy see (vatican city state) honduras hong kong hungary iceland india indonesia iran, islamic republic of iraq ireland israel italy jamaica japan jersey jordan kazakhstan kenya kiribati korea, democratic people's republic of korea, republic of kuwait kyrgyzstan lao people's democratic republic latvia lebanon lesotho liberia libyan arab jamahiriya liechtenstein lithuania luxembourg l’île de man macao macedonia, the former yugoslav republic of madagascar malawi malaysia maldives mali malta marshall islands martinique mauritania mauritius mayotte mexico micronesia, federated states of moldova, republic of monaco mongolia montenegro montserrat morocco mozambique myanmar namibia nauru nepal netherlands netherlands antilles new caledonia new zealand nicaragua niger nigeria niue norfolk island northern mariana islands norway oman pakistan palau palestinian territory, occupied panama papua new guinea paraguay peru philippines pitcairn poland portugal puerto rico qatar romania russian federation rwanda réunion saint helena saint kitts and nevis saint lucia saint pierre and miquelon saint vincent and the grenadines samoa san marino sao tome and principe saudi arabia senegal serbie seychelles sierra leone singapore slovakia slovenia solomon islands somalia south africa south georgia and the south sandwich islands spain sri lanka sudan suriname svalbard and jan mayen swaziland sweden switzerland syrian arab republic taiwan, province of china tajikistan tanzania, united republic of thailand timor-leste togo tokelau tonga trinidad and tobago tunisia turkey turkmenistan turks and caicos islands tuvalu uganda ukraine united arab emirates united kingdom united states united states minor outlying islands uruguay uzbekistan vanuatu venezuela viet nam virgin islands, british virgin islands, u.s. wallis and futuna western sahara '); yemen zambia zimbabwe åland islands
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Date of birth 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 01 02 03 04 05 06 07 08 09 10 11 12 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002	Current situation Student Employed Other	Qualification Labourer Employee, Technician Supervisor Middle management, executive No qualifications Other
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