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Campus*

Your child

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Sex *
Birthdate *
Place of birth *
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Parents

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Private phone
Professional phone
Mobile *
Email *
Parent 2 last name and first name *
Private phone
Professional phone
Mobile *
Email *

Main adress

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Zip code *
City *
Country *

Brothers and sisters

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Birthdate
Brother / sister 2
Birthdate
Brother / sister 3
Birthdate

Remarks(if necessary)

Remarks
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