Application for admission

Motivation

Title
Firstname
Lastname
Street, no
Address suffix
Zip code
City
Country
Private phone no.
Mobilephone
Birthdate
Gender	MaleFemale
Email
Correspondence
Password	The password must be: at least 6 characters long include at least 1 lower case char include at least 1 upper case char include at least 1 number include at least 1 special char
Confirm password	The confirmation password must be identical to the password itself

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