NATIONS UNIES UNITED NATIONS

CERTIFICATE OF ENROLMENT

NAME OF STUDENT: MINKA MBENDE BARTH Student No.:

RODRIGUE

NAME OF STAFF MEMBER: Ecole de Génie Chimique et des

Industries Minérales (EGCIM)

To the Educational Institution:

The above named child of a UNICEF staff member is enrolled in your school. It would be appreciated if
this form is completed and returned to the child's parents. Thank you for your cooperation.

SCHOLASTIC YEAR IN WHICH CHILD IS ENROLLED:

FROM: TO:
DAY/MONTH/YEAR DAY/MONTH/YEAR

IS ATTENDANCE ON FULL-TIME BASIS? YES NO

COURSE: LEVEL:

SEAL OF EDUCATIONAL Name and Title of Officer signing on behalf

INSTITUTION of the educational institution

Signature:

Date:

School Address:

Telephone No.: