SCHEDA DEL PERSONALE VOLONTARIO

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                                               Cognome.                            

                                               Nome.                                  

 

                                               Luogo di Nascita.               

 

                                               Data.                                    

 

                                               Residente.                            

                                               Via.                                      

 

                                               Telefono.                             

                                                                                             

 

FIRMA                                 Iscritto dal.                          

 

                                               Tessera n°.                           

 

 

 

 

Titolo di studio. ________________________Studi in corso. ________________

 

Professione.       ______________________        Lingue conosciute.    _____

 

 

Idoneitą Fisica. _______   H.  _____  Peso.         _____        Donatore. _____

 

Gruppo sanguigno.____________ Allergie.__________

 

Vestiario taglia.___________ Calzature n°._____________