Questionnaire Text

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Individual form

2) Date and location of birth
Born on _ _ (day) _ _ (month) _ _ _ _ (year)
At ____ Municipality (district for Paris, Lyon, Marseille)

Department _ _
DOM (overseas department) number _
Country for those abroad, territory for DOM (overseas territory) ____

If you were born abroad, in what year did you arrive in France?

Year _ _ _ _