-----------------------------------------------------------------------------
country=                       Vietnam
FormTitle=                     BNJ REGISTRATION FORM
department=                    sadhlfjgmv kjk;
submitted=                     Register
purpose=                       academic student
name=                          Nguyen Nhan Loc Thanh
comments=                      nghjgfjhh
phone=                         066 883105
zipcode=                       12345
state=                         08
email=                         locthanh@programmer.net
city=                          Tay Ninh
explanation=                   rtrtr^M
hjkj
fax=
ReceivedDate=                  0:25 wed mar/2003
address=                       Trang Bang