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Personal information:
*
full name:
*
gender:
*
age:
*
nationality:
*
telephone number:
*
E-mail:
Height:
Weight:
*
Duration of stay:
*
Earliest starting date:
*
Marital status:
Do you have any brothers/sisters?
yes
no
*
Education:
*
good knowledge of:
Basic knowledge of:
Special diet considerations:
yes
no
Do you have any health problem or allergies?
yes
no
Do you smoke?
yes
no
Can you swim well?
yes
no
Can you ride a bike?
yes
no
Do you have a driver License?
yes
no
Do you have a First-Aid Training?
yes
no
Religion:
Whether there is a taboo food?
yes
no
about me
*
Confirmation code:
Carry
*
As required