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SIXIEME
CINQUIEME
QUATRIEME
TROISIEME
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Nom et prénom de l'élève
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Nom et adresse de l'établissement scolaire actuel 
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Nom/Prénom/adresse des parents 
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Téléphone 
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Nom et prénom de l'élève
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Nom et adresse de l'établissement scolaire actuel 
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Adresse Mail
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Téléphone 
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