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LOO ZHAO RONG - FIE

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CONSEIL FEMME ET ESCRIME DE LA <strong>FIE</strong> / FORMULAIRE DE<br />

CANDIDATURE 2012<br />

<strong>FIE</strong> WOMEN AND FENCING COUNCIL / 2012 CANDIDATURE FORM<br />

CONSEJO MUJERES Y ESGRIMA DE LA <strong>FIE</strong>/ FORMULARIO DE<br />

1. Identité et coordonnées / Identity and contact details / Identidad y contacto<br />

Nom / Surname / Apellido :<br />

Rondon Gomez<br />

Prénom / Given name / Nombre :<br />

Mayerling Lisbeth<br />

Genre (M/F) / Gender (M/F) / Género (M/F) : Femenina<br />

Date de naissance / Date of birth / Fecha de<br />

nacimiento :<br />

Nationalité / Nationality / Nacionalidad :<br />

Profession / Profession / Profesión :<br />

30 de Agosto de 1986<br />

Venezolana<br />

Licenciada en Educación Inicial<br />

Rue / Street / Calle : La Llanada<br />

No postal et Ville / City and postcode /<br />

Ciudad y código postal :<br />

San Juan de los Morros<br />

Pays /Country / País : Venezuela<br />

Tel : 00584123350381<br />

Fax :<br />

E-mail :<br />

Mobile / celular : mayerling21rondon@hotmail.com<br />

2. Langues parlées / Languages spoken I Idiomas hablados :<br />

FRA ANG ESP Autres /Other / Otros<br />

CANDIDATURA 2012<br />

3. Souhaite recevoir le courrier de la <strong>FIE</strong> / Wishes to receive the <strong>FIE</strong> documents in / Desea recibir el correo de la<br />

<strong>FIE</strong> en :<br />

FRA ANG ESP<br />

4. Diplômes, formation, expérience sportive / Diplomas, education, sport experience / Diplomas, formación,<br />

experiencia deportiva :

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