7/29/2019 BOLETIM_de INSCRIO dos TREINADOR 2013

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REGISTO DE GRADUAES

GRADUAO DATA GRADUAO DATA

VERMELHO III DANCASTANHO IV DANI DAN V DANII DAN VI DAN

N. FOTOS2

BOLETIM DE INSCRIO TREINADOR 2013

NOME COMPLETO: _____________________________________________________________________________________________

________________________________________________________________________________________________________________

MORADA: ______________________________________________________________________________________________________

CDIGO POSTAL: _______________________LOCALIDADE: ________________________________________________________

TELEFONE: ______________________TELEMVEL: ________________________ __________________________________

E-MAIL: _______________________________________________________________________________________________________

NASCIDO A: _____/ _____/ _____ N. B.I. ______________________ ARQUIVO DE: ____________________________________

ESTADO CIVIL: ______________________________PROFISSO: _____________________________________________________

HABILITAES LITERRIAS: ___________________________________________________________________________________

N CEDULA de TREINADOR DE DESPORTO _______________________________________________________________________

CLUBE QUE REPRESENTA: _____________________________________________________________________________

E-MAIL DO CLUBE: ___________________________________________________________________________________

CATEGORIA: NVEL I NVEL II NVEL III NVEL IVCURSO NVEL I

- - CURSO NVEL II - - CURSO NVEL III - -

O TCNICO

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DATA DE ENTRADA A DIRECO DA FPKM

_____/ _____/ _____ _________________________ (ASSINATURA/CARIMBO)