به انجمن حقوق بشري سپيده خوش آمديد     

                  

Address: Sepideh Organization, Postveien 9A, 4044 Hafrsfjord, Norway, Tlf:(+47)90588749

APPLICATION'S FORM TO SEPIDEH THE HUMAN RIGHT GROUP

1

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Dont write in part 1

 

 APPLICATION'S NO:

 

 ORG. CODE:

 

 DATO:

 
MEMBER's NO:

 

 REGISTAR:

 

 REGISTER DATO:

 

 

2

 NAME:

 

 FAMILY NAME:

 

 PSEUDONYM:

 

 BIRTHDAY:

 

 BIRTHPLACE: 

 
LIVING STEAD:

 

 ALLEGIANCE:

 

 JOB:

 

 PROFICIENCY:

 

 STUDY:

 
NATIONALITY:

 

 SEX:

 

 CHILDREN:

 

 MARRIAGE:

 

 LANGUAGE:

 

 

3 ANOTHER LANGUAGE: DIALOG:% WRITER:% READ:% SPEAK:% TRANSLITERATION:%
1:          
2:          
3:          
4:          
5:          

 

4 PROFESSIONALL ACTIVITY:
BACKGROND ACTIVATE:
HOBBY:
RELIGION AND INTEREST:
HOW DO YOU CAN HELP THE SHRA?

 

 

 

5 DO YOU WANT WE USE YOUR NAME INN SEPIDEH'S WEB SITE OR NAME LIST:  NO:   YES:   WITH THIS PSEUDONYM:  
YOUR POST ADDRESS INN YOUR MOTHER CONTRY: 
YOUR POST ADDRESS:

 
HOME TELEPHON:
JOB TELEPHON:
FAX TELEPHON:
MOBIL TELEPHON:
E-MAIL.
HOME PAGE:

 

6 EXPLANATION:

A

  

 
EXPLANATION:

B

  

 
EXPLANATION:

 

C

  

 

 

 

 

7

SIGNATURE:

 

DATO:

 

STEAD:

 

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