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Registration agent:

Personal data * - Fields, obligatory for filling

Name: *

Surname: *

Name in national language:

Date of birth: *

Place of birth:

Place of residence:

Citizenship:

Contact details

Personal E-mail address:

Mobile phone:

Photo:

Data agent

Number of players:

Year start of agent operations:*

The average cost of the players:

The number of agent licenses RFU:

Brief information about the agent:

Authorization data

Personal E-mail address: *

Enter the password: *

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