| DATE OF ENTRY |
1985-6-17 |
|
| CALL YOUR FAVORITE JOB N° I |
designer |
|
| CALL YOUR FAVORITE JOB N° II |
photographic |
|
| FAMILY NAME |
zamora |
|
| FIRST NAME |
inty |
|
| DATE OF BIRTH |
1985-6-17 |
|
| PLACE OF BIRTH |
managua, nicaragua |
|
| NATIONALITY |
nicaraguense |
|
| RELIGION |
---- |
|
| MARITAL STATUS |
single |
|
| HOME ADDRESS / STREET & N° |
managua, ba. altagracias 1 1/2 al lago |
|
| POSTAL CODE (ZIP) |
505 |
|
| CITY |
managua |
|
| COUNTRY |
nicaragua |
|
| NEXT AIRPORT |
sandino airport managua |
|
| YOUR MOBILE N° |
83774992 |
|
| YOUR REGULAR PHONE N° |
Contact mycruiseship.info |
|
| YOUR E-MAIL |
Contact mycruiseship.info |
|
| YOUR ENGLISH LANGUAGE |
medium |
|
| YOUR FRENCH LANGUAGE |
sorry I dont speak that language |
|
| YOUR GERMAN LANGUAGE |
sorry I dont speak that language |
|
| OTHER LANGUAGES |
spanish |
|
| FORMER EMPLOYMENTS - COMPANIES |
genuwine cellasr |
|
| FORMER EMPLOYMENTS - COMPANIES |
cafetalera castellon |
|
| PASSPORT EXPIRE DATE |
2010-00-00 |
|
| VALID SEAMANS BOOK |
no |
|
| NATIONAL LICENSE FOR SEAMAN |
no |
|
| GMDSS NAT. DOC. FOR SEAMAN |
no |
|
| I confirm all the above data are correct |
Yes |
|
| I confirm the right of Wave-Conn to publish my above insert personally data |
Yes |
