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Membership Request:
Personal information (Please type or print clearly in CAPITAL LETTERS) *all fields marked with a star are required for registration --------------------------------------------------------------------------
*Title : Mr. Mrs. Ms. Prof. Dr.
*Membership Types :
Worker Associate Complementary
*First (Given) name: *Middle name: *Last (Family) name:
*Current position:
*Organization:
Address:
Postal code: City: Country:
*Tel: (country code - area code - tel. no.) *Fax: (country code - area code - tel. no.)
*Mob: (country code - area code - cell no.)
*E-Mail address:
Passport number or ID Birthday: (yyyy/mm/dd)
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Registration fee: LE 150
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Tel.: +202 (22918857 – 24148043) Fax: +20224183304 E-mail.: register@cdf-eg.com
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