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      Quick Registration Form

     

    We aim to create a registry of all current and former members of the Zimbabwean Jewish Community and by filling in this form you will help in fulfilling this objective. The data will be kept strictly confidential and will not be given to any 3rd parties for any reason. Apologies for any adverts which may popup - they reduce the cost of running the site significantly.

    Enter Your Name:
    Your Email address: 
    Enter Your Address:
    Enter Your Phone Number :
    Enter your Fax Number :
    Have you got material to contribute - please elaborate ?
    Where you were born:
    tick one only
    Harare (Salisbury)
    Bulawayo
    Mutare (Umtali)
    Kadoma (Gatooma)
    KweKwe (Que Que)

    Other

    		 Where you live now :
    choose one only
    USA
    UK
    Israel
    Zimbabwe
    Australia

    Other
    Your interest in the website :
    Please add any comments below



     

     

     
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