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Inschrijvingsformulier KLJ Nevele werkjaar 2004-2005 Naam:…………………………………………………………………………………..

Inschrijvingsformulier KLJ Nevele werkjaar 2004-2005 Naam:………………………………………………………………………………….. Straat:………………………………………………………………………………….. Gemeente:…………………………………………………………………………….. Telefoonnr:…………………………………GSM nr:………………………………... Email:……………………………………… Uitn per email: Ja Nee

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Inschrijvingsformulier KLJ Nevele werkjaar 2004-2005 Naam:…………………………………………………………………………………..

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  1. Inschrijvingsformulier KLJ Nevele werkjaar 2004-2005 Naam:………………………………………………………………………………….. Straat:………………………………………………………………………………….. Gemeente:…………………………………………………………………………….. Telefoonnr:…………………………………GSM nr:………………………………... Email:……………………………………… Uitn per email: Ja Nee Geboortedatum:………………………….. Geslacht: M V Burgerlijke stand:………………………… Beroep:………………………………… Lidgeld: €18,- €12,- broer/zus die €18,-betaald:……………………………….. €0,- reden:………………………………………………………… 1x proberen - uitnodiging krijgen Leeftijdsgroep: -9 (’96, ’97 of ’98) -12 (’93, ’94 of ’95) jong (’90, ’91 of ’92) oud (’89 of vroeger) +20 (’84 of vroeger) bestuur KLJ (AL)TIJD!

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