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Current address
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Desired date for the move
DD/MM/YYYY
1. Address
2. Apt./Suite
3. City
4. Postal code
5. Building Type
Apartment
Condo
Bungalow
6. Number of room
1 1/2
2 1/2
3 1/2
4 1/2
5 1/2
6 1/2
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7. floor
Ground floor
1st
2e
3rd
Other
8. Elevator ?
Yes
No
Destination address
1. Address
2. Apt./Suite
3. City
4. Postal Code
5. Building Type
Apartment
Condo
Bungalow
6. Number of room
1 1/2
2 1/2
3 1/2
4 1/2
5 1/2
6 1/2
Other
7. Floor
Ground floor
1st
2e
3rd
Other
8. Elevator ?
Yes
No
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CHUM Research Centre Relocation