DEKLARACJO CZUOONKOWSKO ZWIOONZKU LUDNOS'CI NARODOWOS'CI S'LOONSKIJ
DEKLARACJA CZLONKOWSKA ZWIAZKU LUDNOSCI NARODOWOSCI SLASKIEJ
DECLARATION FOR MEMBERSHIP OF PEOPLE'S UNION OF SILESIAN NATIONALITY
SILESIA GROUP INC, P.O. BOX 15823, CLEARWATER, FL 34653, USA

IME (FIRST NAME)___________________NAZWISKO (L. NAME)__________________________
DATA I MIEJSCE URODZYNIO (DATE & PLACE OF BIRTH)_______________________________
ADRESA ZAMIYSZKANIO (ADDRESS)____________________________________
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TELEFOON (PHONE NO.)______________________________________________
CZY CZUJESZ SIE CZUOONKYM NARODU S'LOONSKIGO (DO YOU FEEL MEMBER OF SILESIAN NATIONALITY)_________________
WYRARZOM ZGODA NA PRZISTOOMPIYNIE DO ZWIOONZKU LUDNOS'CI 
NARODOWOS'CI S'LOONSKIJ. WYRARZOOM ZGODA NA URZYWANIE MOIH DANYH DLO POCZEB ZLNS'.
I AGREE TO BECOME MEMBER OF PEOPLE'S UNION OF SILESIAN NATIONALITY. I AGREE TO USE OF MY PERSONAL DATA FOR USE IN ZLNS' (PEOPLE'S UNION OF SILESIAN NATIONALITY).

PODPIS (SIGNATURE)___________________________DATA (DATE)____________________

WYKSZTAUCYNIE (EDUCATION)__________________________________________________
FAH (PROFESSION)_______________________________________________________________
ZNAJOOMOS'C' JYNZYKOOW (FOREIGN LANGUAGES)_________________________________
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ZAINTERESOWANIA POMOCNE W DZIAUALNOS'CI DLO ZLNS'
HOW CAN YOU HELP PEOPLE'S UNION OF SILESIAN NATIONALITY
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NIY WYPISYWAC' - RUBRYKI DO WYPEUNIYNIO PRZEZ ZARZOOND ZLNS' ( DO NOT FILL OUT - TO BE FILLED OUT BY COMMITTEE ZLNS')

DECYZJO UO PRZIJYN'CIU DO ZLNS' (DECISSION)___________________________________
DATA (DATE)__________________MIEJSCOWOS'C' (PLACE)_______________________________
PODPIS (SIGNATURE)__________________________PIECZYN'C' (SEAL)____________________
LEGITYMACJO NUMER (MEMBERSHIP NO)_______________________________________________
INKSZE (OTHERS)________________________________________________________________