Email address (if applicable) : Last school attended

FORM FOR ENROLMENT FOR MELS EXAM
REWRITES IN JULY/AUGUST 2014
PERSONAL INFORMATION
Family Name:
First Name:
Telephone number:
Email address (if applicable) :
Last school attended :
Year last attended :
EXAM INFORMATION
Exam title:
Exam code:
Date of exam:
School in which the exam will be taken :
Signature of student:
SEND TO LOUISE JONCAS (CSL CHEVERY)
email: [email protected]
Fax: 418-787-2348
RÉSERVÉ À LA DIRECTION
Inscrit le :
Par:
Versé dans Charlemagne le:
Expédier une copie aux services éducatifs à l'attention de Debbie Foltin
Revised June 2014