ANSWER SHEET

All lines with * are obligatory.

STATION
*
 
BROADCAST
Month * Day *
Hour * Minute
 
MAGAZINE
INITATIVE AFRICA
NUMBER
* The number is necessary. If you have forgotten it, please visit the Archives.
 
N° AND THEME OF REPORT
*
   
Title : Mr Mrs *
Family name : *
First name : *
Age ans. *
Adress : *
Postal code :
City : *
Country : *
Phone : *
Mobile :
Fax
E.Mail
Company :
Profession *
Sector : *
 

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