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Fill in all the fields of the following form if you want to become a member of Gent x Formentera. You will receive an answer as soon as possible with all the necessary information to complete the inscription. Thank you.

Full name:	DNI / Pass:

Address:	Been born:

Telephone:	Email:


Mr/Mrs/Ms/Miss ... requests his\|her membership to Gent per Formentera, will obey its regulations and assum its Ideological Guidelines, and declares he/she is not a member of any other political group th executive have not been previously briefed about.

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