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Title * Mr. Mrs Miss Family Mr/Mrs
First name *
Lastname *
Address 1 *
Address 2
PostCode *
City *
Country * Afghanistan Albania Antarctica Algeria American Samoa Andorra Angola Antigua and Barbuda Azerbaijan Argentina Australia Austria Bahamas Bahrain Bangladesh Armenia Barbados Belgium Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil Belize British Indian Ocean Territory Solomon Islands British Virgin Islands Brunei Darussalam Bulgaria Myanmar Burundi Belarus Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Sri Lanka Chad Chile China Taiwan Christmas Island Cocos (Keeling) Islands Colombia Comoros Mayotte Republic of the Congo The Democratic Republic Of The Congo Cook Islands Costa Rica Croatia Cuba Cyprus Czech Republic Benin Denmark Dominica Dominican Republic Ecuador El Salvador Equatorial Guinea Ethiopia Eritrea Estonia Faroe Islands Falkland Islands South Georgia and the South Sandwich Islands Fiji Finland Åland Islands France French Guiana French Polynesia French Southern Territories Djibouti Gabon Georgia Gambia Occupied Palestinian Territory Germany Ghana Gibraltar Kiribati Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guyana Haiti Heard Island and McDonald Islands Vatican City State Honduras Hong Kong Hungary Iceland India Indonesia Islamic Republic of Iran Iraq Ireland Israel Italy Côte d'Ivoire Jamaica Japan Kazakhstan Jordan Kenya Democratic People's Republic of Korea Republic of Korea Kuwait Kyrgyzstan Lao People's Democratic Republic Lebanon Lesotho Latvia Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macao Madagascar Malawi Malaysia Maldives Mali Malta Martinique Mauritania Mauritius Mexico Monaco Mongolia Republic of Moldova Montserrat Morocco Mozambique Oman Namibia Nauru Nepal Netherlands Netherlands Antilles Aruba New Caledonia Vanuatu New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Norway Northern Mariana Islands United States Minor Outlying Islands Federated States of Micronesia Marshall Islands Palau Pakistan Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Guinea-Bissau Timor-Leste Puerto Rico Qatar Réunion Romania Russian Federation Rwanda Saint Helena Saint Kitts and Nevis Anguilla Saint Lucia Saint-Pierre and Miquelon Saint Vincent and the Grenadines San Marino Sao Tome and Principe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia Vietnam Slovenia Somalia South Africa Zimbabwe Spain Western Sahara Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Tajikistan Thailand Togo Tokelau Tonga Trinidad and Tobago United Arab Emirates Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine The Former Yugoslav Republic of Macedonia Egypt United Kingdom Isle of Man United Republic Of Tanzania United States U.S. Virgin Islands Burkina Faso Uruguay Uzbekistan Venezuela Wallis and Futuna Samoa Yemen Serbia and Montenegro Zambia
Date of birth dd/mm/yyyy
Email. eg. lea@mymail.com
Précisions à apporter (Tranche d'âge souhaitée, visite du filleul prévue ou non,...)
Children of the Mekong is a registered charity providing education to children in South-East Asia. In a nutshell:
Email * e.g. jo.bloggs@email.com
Title * Mr Mrs Miss Mr & Mrs
First Name * David
Last Name * Beckham
Address 1 * e.g. 123 Streetson Road
Address 2 e.g. Greenwich
Postcode *e.g. W1K 1BE
City * e.g. London
Country * United-Kingdom BELGIUM FRANCE SINGAPORE SWITZERLAND UNITED KINGDOM ---------------------------------- AFGHANISTAN ÅLAND ISLANDS ALBANIA ALGERIA AMERICAN SAMOA ANDORRA ANGOLA ANGUILLA ANTARCTICA ANTIGUA AND BARBUDA ARGENTINA ARMENIA ARUBA AUSTRALIA AUSTRIA AZERBAIJAN BAHAMAS BAHRAIN BANGLADESH BARBADOS BELARUS BELGIUM BELIZE BENIN BERMUDA BHUTAN BOLIVIA, PLURINATIONAL STATE OF BOSNIA AND HERZEGOVINA BOTSWANA BOUVET ISLAND BRAZIL BRITISH INDIAN OCEAN TERRITORY BRUNEI DARUSSALAM BULGARIA BURKINA FASO BURUNDI CAMBODIA CAMEROON CANADA CAPE VERDE CAYMAN ISLANDS CENTRAL AFRICAN REPUBLIC CHAD CHILE CHINA CHRISTMAS ISLAND COCOS (KEELING) ISLANDS COLOMBIA COMOROS CONGO CONGO, THE DEMOCRATIC REPUBLIC OF THE COOK ISLANDS COSTA RICA CÔTE D'IVOIRE CROATIA CUBA CYPRUS CZECH REPUBLIC DENMARK DJIBOUTI DOMINICA DOMINICAN REPUBLIC ECUADOR EGYPT EL SALVADOR EQUATORIAL GUINEA ERITREA ESTONIA ETHIOPIA FALKLAND ISLANDS (MALVINAS) FAROE ISLANDS FIJI FINLAND FRANCE FRENCH GUIANA FRENCH POLYNESIA FRENCH SOUTHERN TERRITORIES GABON GAMBIA GEORGIA GERMANY GHANA GIBRALTAR GREECE GREENLAND GRENADA GUADELOUPE GUAM GUATEMALA GUERNSEY GUINEA GUINEA-BISSAU GUYANA HAITI HEARD ISLAND AND MCDONALD ISLANDS HOLY SEE (VATICAN CITY STATE) HONDURAS HONG KONG HUNGARY ICELAND INDIA INDONESIA IRAN, ISLAMIC REPUBLIC OF IRAQ IRELAND ISLE OF MAN ISRAEL ITALY JAMAICA JAPAN JERSEY JORDAN KAZAKHSTAN KENYA KIRIBATI KOREA, DEMOCRATIC PEOPLE'S REPUBLIC OF KOREA, REPUBLIC OF KUWAIT KYRGYZSTAN LAO PEOPLE'S DEMOCRATIC REPUBLIC LATVIA LEBANON LESOTHO LIBERIA LIBYAN ARAB JAMAHIRIYA LIECHTENSTEIN LITHUANIA LUXEMBOURG MACAO MACEDONIA, THE FORMER YUGOSLAV REPUBLIC OF MADAGASCAR MALAWI MALAYSIA MALDIVES MALI MALTA MARSHALL ISLANDS MARTINIQUE MAURITANIA MAURITIUS MAYOTTE MEXICO MICRONESIA, FEDERATED STATES OF MOLDOVA, REPUBLIC OF MONACO MONGOLIA MONTENEGRO MONTSERRAT MOROCCO MOZAMBIQUE MYANMAR NAMIBIA NAURU NEPAL NETHERLANDS NETHERLANDS ANTILLES NEW CALEDONIA NEW ZEALAND NICARAGUA NIGER NIGERIA NIUE NORFOLK ISLAND NORTHERN MARIANA ISLANDS NORWAY OMAN PAKISTAN PALAU PALESTINIAN TERRITORY, OCCUPIED PANAMA PAPUA NEW GUINEA PARAGUAY PERU PHILIPPINES PITCAIRN POLAND PORTUGAL PUERTO RICO QATAR RÉUNION ROMANIA RUSSIAN FEDERATION RWANDA SAINT BARTHÉLEMY SAINT HELENA, ASCENSION AND TRISTAN DA CUNHA SAINT KITTS AND NEVIS SAINT LUCIA SAINT MARTIN SAINT PIERRE AND MIQUELON SAINT VINCENT AND THE GRENADINES SAMOA SAN MARINO SAO TOME AND PRINCIPE SAUDI ARABIA SENEGAL SERBIA SEYCHELLES SIERRA LEONE SINGAPORE SLOVAKIA SLOVENIA SOLOMON ISLANDS SOMALIA SOUTH AFRICA SOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDS SPAIN SRI LANKA SUDAN SURINAME SVALBARD AND JAN MAYEN SWAZILAND SWEDEN SWITZERLAND SYRIAN ARAB REPUBLIC TAIWAN, PROVINCE OF CHINA TAJIKISTAN TANZANIA, UNITED REPUBLIC OF THAILAND TIMOR-LESTE TOGO TOKELAU TONGA TRINIDAD AND TOBAGO TUNISIA TURKEY TURKMENISTAN TURKS AND CAICOS ISLANDS TUVALU UGANDA UKRAINE UNITED ARAB EMIRATES UNITED KINGDOM UNITED STATES UNITED STATES MINOR OUTLYING ISLANDS URUGUAY UZBEKISTAN VANUATU VENEZUELA, BOLIVARIAN REPUBLIC OF VIET NAM VIRGIN ISLANDS, BRITISH VIRGIN ISLANDS, U.S. WALLIS AND FUTUNA WESTERN SAHARA YEMEN ZAMBIA ZIMBABWE
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The information and personal data collected on this form are recorded in a confidential digital file for Children of the Mekong. Your personal data will never be communicated to third parties under any circumstances, as we have done since the beginning of the charity in 1958. You can read our privacy policy. In accordance with the GDPR regulation, you can exercise your right of access to personal data and request correction by contacting Children of the Mekong by email to info@childrenofthemekong.org.
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