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Diplomado "Juventudes Progresistas" 1a Generación
Datos Generales.
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* Indicates required question
Apellido Paterno:
*
Your answer
Apellido Materno:
*
Your answer
Nombre(s):
*
Your answer
Sexo:
*
Choose
Masculino
Femenino
Fecha de nacimiento:
*
MM
/
DD
/
YYYY
Ciudad:
*
Your answer
Estado:
*
Your answer
Correo electrónico:
*
Your answer
Teléfono móvil:
*
10 dígitos
Your answer
Escolaridad:
*
Ninguna
Primaria
Secundaria
Bachillerato
Universidad
Posgrado
Ocupación:
*
Your answer
¿Militante o simpatizante del PRD?
*
Militante
Simpatizante
Facebook:
Ejemplo:
www.facebook.com/JuventudesDeIzquierda.PRD
Your answer
Twitter:
Ejemplo: @JIZ_PRD
Your answer
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