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Name: ..

Surnames: . ...
Age: marital status: .. .
Address: ZIP. ..

City: .
Tel / Fax: E. mail: .
..
N document identity: Nationality (s): ..
. ...
Current Occupation: ..
Has knowledge of the statutes and aims of the Foundation? .. ..
Agrees to comply with the requirements set forth? ..
Briefly explain the reasons why you want to be part of the Foundation:

.
Signature: _______________________________________
C. C. _____________________
N. b. In short we will communicate the acceptance or denial of your request.
Please send your request by mail (fsmpanolaima@gmail.com ), either by mail to:
P. Angel Alfaro Rivero / Casa San Martin de Porres - Vda. The Maria - anolaima Cundinamarc