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First Name: Middle Initial: Last name: Phone Number: Address: Gender: Male Female Birthday: January Febrary March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 22 23 24 25 26 27 28 29 30 31 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 Religion: Catholic Iglesia 7thday Adventist Methodist Mormons Born Again Civil Status: Single Married City/Province: Bayombong Isabela Manila Pampanga Tarlac Country: Canada China Phillipines Thailand