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	Personal Data		Licence Data
Name:		Club:	--- Select --- Amicale Foyer AS CFL AS PTT BBC BIL BBC Cargolux BBC CSSF Caceis Ecobasket BBC Police Grand-Ducale BBC Team Teaching Black Lions BBH Titans - Brown Brothers Harriman EIB Basketball Club Eurobasket Club Lux-Ballers EY Luxembourg Spuerkees Staater Léiwen ITM Miners The Arcelormittal Steelers BNP Parisbas Luxembourg Societe Generale Band and Trust Docler Holding
First Name:		Licence N°:
Gender (M or F):		Licence A/B/C/O:	--- Select --- A B C O
Birthday:		Last Medical Exam:
Nationality:		Licence FLBB:	Yes        No
		Club FLBB: