MEMBERSHIP REGISTRATION FORM

With this form I declare that I wish to enroll as a member of the political party “Eleftheri Patrida” and that I fully accept its believes as stated in its Manifesto whilst supporting unconditionally its positions and purpose I accept that the personal information declared here below on my behalf will be registered by the political party and may be used according to compliance with and expectation as set out by Greek legislation.
Last Name(*)
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Name(*)
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Father's Name(*)
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Profession(*)
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HOME ADDRESS
Address(*)
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Number(*)
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P.O.(*)
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Municipality / Community to vote(*)
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No. Identity Card(*)
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Date of Birth(*)
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TELEPHONES
Mobile(*)
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Local(*)
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Email(*)
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Area of Voluntary participation
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I'm not a robot
I'm not a robot
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