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Name:

E-mail:

Date of Birth:

Marital Status:

Period of Membership

Yearly

Type of Membership

Couple Single Family

Please complete the section below:

Name of Spouse:

Date of Birth:

Names(s) of Children

1.		Date of Birth:
2.		Date of Birth:
3.		Date of Birth:
4.		Date of Birth:

Profession:

Employer:

Address:

Telephone Numbers:

Home:

Office:

Mobile:

Hobbies

	The Diplomatic Club, P.O Box 3395, Doha, Qatar \| Tel. No.: +974 484 7444 \| Fax : +974 4839001 Copyright 2008 The Diplomatic Club, All rights researved.