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    STUDENT:

    En Classe de :

    Full name

    Date of birth

    Place of birth

    Nationality

    Home address

    City

    Tel

    Last educational institution attended

    PublicPrivat

    Family record

    Father

    Mother

    Full name

    Full name

    Occupation

    Occupation

    Work Address

    Work Address

    Tel

    Tel

    E-mail

    E-mail

    Emergency Contact(s)

    Full name

    Home Phone

    Mobile

    Brothers and Sisters :

    Full name

    Year of Birth

    School or Occupation

    Special Circumstances (death, separation, etc.)

    Legal guardian of the child (Attach a certificate mandatory)

    Full name

    Home Address

    Tel

    Person responsible for tuition payment

    Full name

    Home address

    Tel

    Other information

    Reason for requesting enrollment at Sud institution

    Various activities already practiced

    Artistic, cultural, sports activities