| State or Province | mazowieckie |
|---|
| City | Ciechanów |
|---|
| Country | Polska |
|---|
| Postal Code | 06-400 |
|---|
| Name on Certificate | Maciej Dariusz Kraszewski |
|---|
| Name on Name Tag | Maciej Dariusz Kraszewski |
|---|
| State on Name Tag - US Residents Only | – |
|---|
| Country on Name Tag | POLSKA |
|---|
| Would you like to be added into the Live Event JMT App Directory? | No - Do NOT Include Me in Event Directory |
|---|
| Spanish Members - Would you prefer your event materials in Spanish? | – |
|---|
| Live Translation | – |
|---|
| Spanish Preferred Language | – |
|---|
| Spanish Activities Participation | – |
|---|
| Dietary Needs | – |
|---|
| Special Accomidations | – |
|---|
