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NG K THAM GIA TP HUN

H v Tn..................................................................................................................................................
Sinh ngy......................Thng.................Nm.......................

Nam hay N......................................

Chiu cao........................Trng lng C th...................Trnh vn ha.............................................

Qu

qun.................................................................................................................................................

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Ni hin nay.........................................................................................................................................
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S in thoi.................................................

S di ng ...................................................

E-mail...............................................................................................................................................
Ngh

nghip

hc..........................................................................................................................

Ngh

nghip

ang

lm....................................................................................................................

Tnh trng sc khe ca anh, ch ( ngh ghi c th)..............................................................

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Kha tp hun m anh, ch mun ng k (ghi tn ca kha hc)...........................................
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(Cu hi dnh ring cho Kha tp hun gim trng lng....) S Kg cn gim......................
Anh, ch s dng bin php gim cn no cha..................................................................
..................................................................................................... My ln ri.......................................
a im anh, ch mun tham gia ti khu vc no (pha Nam hay Bc)...................................
Nguyn

vng ph ca

anh,

ch

(nu c)................................................................................

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Bn bit n Kho tp hun ny do u?
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C ngi gii thiu (Ghi r tn ngi gii thiu).

Trang web ca trung tm.

T cc trang tm kim .

T cc din n (nu r tn din n)

T cc ngun khc (ghi r ngun) .

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Ngy................Thng....................Nm..........................................................................................
Ngi ng k........................................................ Ch k ca B hoc M (nu di 18 tui)
Ch k............................................................................Ch k..............................................................
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H-Tn....................................................................H-Tn..............................................................