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\fs20\lang1024\langfe1024\cgrid\langnp1024\langfenp1024 \snext11 \ssemihidden Normal Table;}}{\*\rsidtbl \rsid2229336\rsid2438714\rsid8132112\rsid8721339\rsid14043182} {\*\generator Microsoft Word 10.0.6835;}{\info{\author Collectief}{\operator Eric}{\creatim\yr2008\mo1\dy21\hr14\min9}{\revtim\yr2008\mo1\dy30\hr17\min37}{\version6}{\edmins6}{\nofpages1}{\nofwords731}{\nofchars4022}{\*\company GGD Zuid-Holland Noord} {\nofcharsws4744}{\vern16393}{\*\password 00000000}}{\*\xmlnstbl }\paperw12240\paperh15840\margl1417\margr1417\margt1417\margb1417\gutter0 \widowctrl\ftnbj\aenddoc\hyphhotz425\grfdocevents0\noxlattoyen\expshrtn\noultrlspc\dntblnsbdb\nospaceforul\hyphcaps0\horzdoc\dghspace120\dgvspace120\dghorigin1701\dgvorigin1984\dghshow0\dgvshow3 \jcompress\viewkind1\viewscale100\nolnhtadjtbl\rsidroot8132112 \fet0{\*\wgrffmtfilter 013f}\sectd \linex0\headery708\footery708\colsx708\sectdefaultcl\sftnbj {\*\pnseclvl1\pnucrm\pnstart1\pnindent720\pnhang {\pntxta .}}{\*\pnseclvl2 \pnucltr\pnstart1\pnindent720\pnhang {\pntxta .}}{\*\pnseclvl3\pndec\pnstart1\pnindent720\pnhang {\pntxta .}}{\*\pnseclvl4\pnlcltr\pnstart1\pnindent720\pnhang {\pntxta )}}{\*\pnseclvl5\pndec\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}{\*\pnseclvl6 \pnlcltr\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}{\*\pnseclvl7\pnlcrm\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}{\*\pnseclvl8\pnlcltr\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}{\*\pnseclvl9\pnlcrm\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}\pard\plain \ql \li0\ri0\nowidctlpar\wrapdefault\faauto\rin0\lin0\itap0 \fs24\lang1043\langfe1043\cgrid\langnp1043\langfenp1043 {\f1\fs22\insrsid2229336 Dit formulier is voor witte illegalen die }{ \f1\fs22\insrsid8132112\charrsid8132112 willen meedoen aan de actie }{\f1\fs22\insrsid2438714 voor een generaal pardon voor alle witte illegalen }{\f1\fs22\insrsid8132112\charrsid8132112 in Nederland.}{\f1\fs22\insrsid2229336 }{ \f1\fs22\insrsid8132112\charrsid8132112 Het aanmelden kunt u doen door dit formulier compleet in te vullen}{\f1\fs22\insrsid8132112 en ondertekend op}{\f1\fs22\insrsid2438714 te }{\f1\fs22\insrsid8132112 sturen naar De Fabel van de illegaal, Koppenhinksteeg 2, 2312HX Leiden}{\f1\fs22\insrsid2229336 , e-mail: info@defabel.nl, of fax: 071-5134907}{\f1\fs22\insrsid8132112\charrsid8132112 . \par \par }{\b\f1\fs22\ul\insrsid8132112\charrsid8132112 Persoonsgegevens: \par }{\f1\fs22\insrsid8132112\charrsid8132112 Datum eerste IND aanvraag\tab \tab : .......................................................................................... \par Voorletters\tab \tab \tab }{\f1\fs22\insrsid8721339 \tab }{\f1\fs22\insrsid8132112\charrsid8132112 :............................................................................................ \par Tussenvoegsels en achternaam\tab :............................................................................................ \par Roepnaam\tab \tab \tab }{\f1\fs22\insrsid8721339 \tab }{\f1\fs22\insrsid8132112\charrsid8132112 :............................................................................................ \par Geslacht (m/v)\tab \tab \tab }{\f1\fs22\insrsid8721339 \tab }{\f1\fs22\insrsid8132112\charrsid8132112 :............................................................................................. \par Geboortedatum\tab \tab \tab :............................................................................................. \par Geboorteplaats\tab \tab \tab :............................................................................................. \par Geboorteland\tab \tab \tab }{\f1\fs22\insrsid8721339 \tab }{\f1\fs22\insrsid8132112\charrsid8132112 :............................................................................................. \par \par }{\b\f1\fs22\ul\insrsid8132112\charrsid8132112 Huidige soort werk}{\f1\fs22\insrsid8132112\charrsid8132112 : \par }{\i\f1\fs22\insrsid8132112\charrsid8132112 Werkervaring }{\f1\fs22\insrsid8132112\charrsid8132112 \tab Ik heb minstens .........jaar ervaring in de beroepspraktijk ja () neen () \par \tab \tab Soortberoep\tab }{\f1\fs22\insrsid8721339 \tab }{\f1\fs22\insrsid8132112\charrsid8132112 :.................................................................................... \par \tab \tab Naam bedrijf (1)\tab :.................................................................................... \par \tab \tab Naam bedrijf (2)\tab :....................................................................................\tab \par \tab \tab Naam bedrijf (3)\tab :.................................................................................... \par \tab \tab Naam bedrijf(4)\tab :..................................................................................... \par Ik ben in Nederland sinds\tab \tab :..........-...........-............................................................. \par Adres\tab \tab \tab \tab }{\f1\fs22\insrsid8721339 \tab }{\f1\fs22\insrsid8132112\charrsid8132112 :.................................................................................... \par Postcode en woonplaats\tab \tab :.................................................................................... \par Postadres\tab \tab \tab }{\f1\fs22\insrsid8721339 \tab }{\f1\fs22\insrsid8132112\charrsid8132112 :................................................................................... \par Postcode en plaats\tab \tab \tab :.................................................................................. \par \par }{\b\f1\fs22\insrsid8132112\charrsid8132112 Handtekening voor akkoord\tab }{\f1\fs22\insrsid8132112\charrsid8132112 :................................................................................... \par \par Naam advocaat\tab \tab \tab :................................................................................... \par Postbus en woonplaats\tab \tab :................................................................................... \par Telefonnummer\tab \tab \tab :................................................................................... \par Emailadres\tab \tab \tab }{\f1\fs22\insrsid8721339 \tab }{\f1\fs22\insrsid8132112\charrsid8132112 :................................................................................... \par Dossiernummer IND\tab \tab \tab :................................................................................... \par Contactpersoon ( dhr./mevr.)\tab \tab :................................................................................... \par ..................................................................................................................................................... \par }{\b\f1\fs22\insrsid14043182 Stemp}{\b\f1\fs22\insrsid8132112\charrsid8132112 el, handtekening }{\f1\fs22\insrsid8132112\charrsid8132112 van organisatie, maatschappelijk werker, arts, specialist, psychiater of ziekenhuis: \par .................................................................................................................................................... \par .................................................................................................................................................... \par .................................................................................................................................................... \par }{\b\f1\fs22\insrsid8132112\charrsid8132112 Omschrijving van ziekte, gezondheidsklachten en behandeling: \par }{\f1\fs22\insrsid8132112\charrsid8132112 .................................................................................................................................................... \par ................................................................................................................................................... \par \par }{\b\f1\fs22\insrsid8132112\charrsid8132112 Burgernummer / sofi-nummer }{\f1\fs22\insrsid8132112\charrsid8132112 \tab :.................................................................................. \par }{\b\f1\fs22\insrsid8132112\charrsid8132112 Paspoortnummer\tab \tab }{\b\f1\fs22\insrsid8721339 \tab }{\f1\fs22\insrsid8132112\charrsid8132112 :.................................................................................. \par }{\b\f1\fs22\insrsid8132112\charrsid8132112 Paspoortnummer\tab \tab }{\b\f1\fs22\insrsid8721339 \tab }{\f1\fs22\insrsid8132112\charrsid8132112 :.................................................................................. \par Geldig tot en met \tab \tab \tab :.................................................................................. \par Afgegeven op ( datum)\tab \tab :.................................................................................. \par }}