1. Cosmo bali mEmbER DaTa
ABOUT YOURSELF
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Pet name : ………………………………………………………………………………………………………
Home Address : ………………………………………………………………………………………………………
Home Phone : ………………………………………………………………………………………………………
Status : ………………………………………………………………………………………………………
Place & DOB : ………………………………………………………………………………………………………
Hobby : ………………………………………………………………………………………………………
ABOUT YOUR JOB
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Field : ………………………………………………………………………………………………………
Position : ………………………………………………………………………………………………………
Business Address : ………………………………………………………………………………………………………
Business Phone : ………………………………………………………………………………………………………
HOW TO CONTACT YOU
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Messenger : ………………………………………………………………………………………………………
YM/MSN/ICQ
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Bali, ……………….
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