Sign up and put your name and email address on the deaf directory


	Deaf People in Malaysia

You are welcome to fill up this form if you want your name and email address registered in the deaf directory for email communication. This form directly emails to my email account. I will check your application form and update it to the web page as easily as possible. Thanks. ^0^

*Name:		Gender:	Male Female
*E-Mail:		Age:
Address:
City:		Fax No:
State:		ICQ No:
Country		Zip:
URL:
D.O.B:	(dd) (mm) (yy)	Occupation:
* Required Field

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