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Registration Form 34th Southern Cross Brigade to Cuba 2016/2017 The information in this form must be the same as appears in your current passport. Please print clearly in block letters. Surname: ............................................................
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1984 2017 Brigadistas Marti ICAP Postcode ACFS BSB 3pm Societys AU1000 AU1100 34th 24hr NZ MIRRABOOKA Wk Expiry Mb Acc organisations dietary uni Gossamer Conversational participants payable solidarity affiliated Nationality Surname Cubans

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