ENRO LM EN T FO R M

EUROPEAN BACHELOR
European Accreditation Board
of Higher Education Schools
Collège européen d’accréditation
des universités et des grandes écoles

Photo

To be completed by the school

BACHELOR:
MAJOR:
Duration of studies: Date of BA programme end:

Please type your responses in the spaces provided below

Surname: ouertani First Name: med khalil

Date of birth: 27/06/99 Country of citizens: Tunisia

Place of birth: (City/State/ Country): Beja

Passport / National Identity Card Number: 12351593

Student address:

Rue 20 mars Boussalem

Zip code: 8170 City/State: Boussalem Country: Tunisia
E-mail: khalilouertano24@gmail.com

Permanent address (where the diploma will be sent):

rue 20 mars
Zip code: 8170 City/State: Boussalem Country: Tunisia
Daytime telephone number: Mobile: 24443027

Name of the Higher Educational Institution in which you have enrolled:

École Supérieure Européenne Libre de Tunis

Zone d'activité Khaireddine - Kram
Lot 1130 - Les Berges du Lac II
2015 Tunis - Tunisia

Department of studies:

Degree to be obtained:

E.A.B.H.E.S. Europe - 116 rue du Bac - 75007 PARIS - France PAGE 1

 EUROPEAN BACHELOR EN ROL M E NT FO R M

List all European countries you have visited:

UK
List all European countries where you have lives more than 6 months (and duration):

Diploma obtained or to be obtained in high school: BAC Year: 2019

Obtained:  Yes  No
Name, city, country of the high school:

Boussalem
Native language(s): english
Languages studied in high school: english frensh
Level of proficiency in English (on a scale of 0 to 6): 3
If you have taken any International language tests (TOEIC, TOEFL, Cambridge Exams, IELTS, GMAT),
please indicate the name of the test:

The Test(s): english Score: A2 Year: 2018

Other international language certificates obtained (name, date, and score):

List every college, university, professional school, or other higher institution previously attended,
even partially, and indicate degrees obtained and the year*:
Educational institution Name-city-country Dates of attendance Degree Major Graduation year

>> * Please join a copy of test results and grade transcripts, so that E.AB.H.E.S can allot your credits

Date: Signature:

>> Please return the following document dully filled, dated and signed
to your educational institution by
Together with:
• 1 recent identity photography-standard size
• Any proof relevant to your previous higher education studies and foreign language certification
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