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RING 14 NON-PROFIT ASSOCIATION
HELP AND RESEARCH FOR CHILDREN WITH RARE GENETIC DISEASES

Please make a donation

Registration form

Registration form
Nickname:
E-mail:
Data of father
Surname:
First name:
E-mail:
Your Facebook Profile Address:
Your Personal Website Address:
Your Twitter Address:
Telephone:
Address:
City:
Zone:
Postcode:
Country:
Data of mother
Surname:
First name:
E-mail:
Your Facebook Profile Address:
Your Personal Website Address:
Your Twitter Address:
Telephone:
Address:
City:
Zone:
Postcode:
Country:
Data of child
First name:
Date of birth:
Which one of these chromosome 14 aberrations has affected your kid?:
Enter Karyotype:
Please describe your interest in Ring14 and how we might best serve you:
How did you find us?:
Is there anything else you would like to share with us?:
Conditions:
I have read and accepted the conditions for registration

To register on our website please enter into the form above your full name, e-mail address and indicate why you are interested in our association.

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