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    ■   ■   ■   ■   ■                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   ■ ╒═╒Ь.УЧ+,∙о0h8@ HPX`фA ■      └FMicrosoft Publisher 3.0MSPublisher.3Ї9▓q■      ┌Ў╚ЭЦ╤О└O╢■╬Quill96 Story Group Class    Ї9▓q■ рЕЯЄ∙OhлС+'│┘0@ фG╓?    К т уb  Рf%ў            ААА└└└ААААААААА45bC ╠РfРf(fРА:ААААААААА└└└└▄└Ё╩ж @ ` А а └ р@@ @@@`@А@а@└@р`` `@```А`а`└`рАА А@А`АААаА└Араа а@а`аАааа└ар└└ └@└`└А└а└└└ррр р@р`рАрар└рр@@ @@@`@А@а@└@р@ @ @ @@ `@ А@ а@ └@ р@@@@ @@@@@`@@А@@а@@└@@р@`@` @`@@``@`А@`а@`└@`р@А@А @А@@А`@АА@Аа@А└@Ар@а@а @а@@а`@аА@аа@а└@ар@└@└ @└@@└`@└А@└а@└└@└р@р@р 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)h~м"р Yhh╝Мr~ИК╛Мr~ИКCCFFA=11Иv 55}tjlnNN"" ╥▓4@BDFHJLNPRTVXZ\^`bhИlДnЖjК░╨   ╞vА6@C288├$$N╚╚pp X8#2 #  8ЦЦОФ  -   ▐Ё.,ммMj ╨└Ъ└8 └и └"@^@Ї@К@═@@P@Б@"@'>@(╝@ └.└z└Ш└.▓└╠рц└└)р,рdр#$└$#,└%#и└╬└Ў└└X└0Ш@N@2U@3╒@VU@jТ@4j└@Tj@@^}@[¤@L@@RГ@f╞@Wf°@\f|@1\:@/\ё@Ofк @,fч @Pg!@Sд!└cSь!@QSl"@HQЪ"@-Q#@dSW#@JS╫#@IS$@XSФ$@_S┌$@gS%@hgK%@ig╦%@YS&@MSE&@eS┼&@ SE'@ SИ'@aS╦'@ S(@SQ(@!Ф(└&╝(@ ф(└╥▓@[sа%г 7.)#S!& )88°|T МT*FXdf~А @[sа%гCanon LBP-660winspoolLPT1:Samsung ML-1710 SeriesPФДo Ъ 4dXX227 4Ъ dS1HSamsung ML-1710 Series*,.02╞╚ @[sа%гAlors de l'enregistrement dans ce format.6pp                        аЁ(L$,4<DL╖ A╖@Aи A▐ Aр A* A "'(▓Мф└ф└ф└■ ф└ф└ф└    ┤Мф└ф└ф└■ ф└ф└ф└    9Cф└ф└ф└FDPCFDPC@FDPCFDPCBFDPCFDPCDFDPCFDPCFFDPCFDPCH Nom et prщnom des parents : Pшre : Mшre : Nom : Nom : Prщnom : Prщnom : Nationalitщ : Nationalitщ : Tщlщphone portable : & & & / & & & / & & & / & & & / & & & Tщlщphone portable : & & & / & & & / & & & / & & & / & & & Coordonnщes professionnelles des parents : Les numщros de tщlщphones sont indispensables ! Pшre : Mшre : Profession : Profession : Entreprise : Entreprise : Ville : Ville : tщl : & & & & .. / & & & & .. / & & & & .. / & & & & .. / ............ tщl : & & & & .. / & & & & .. / & & & & .. / & & & & .. / ............ Adresses seulement si diffщrentes de l'enfant : Les numщros de tщlщphones sont indispensables ! Pшre : Mшre : n░, rue : n░, rue : ville : ville : tщl : & & & & .. / & & & & .. / & & & & .. / & & & & .. / ............ tщl : & & & & .. / & & & & .. / & & & & .. / & & & & .. / ............ Coordonnщes complщmentaires de personnes proches si nщcessaire : Nom 1 : Nom 2 : adresse : adresse : Ville : Ville : tщl : & & & & .. / & & & & .. / & & & & .. / & & & & .. / ............ tщl : & & & & .. / & & & & .. / & & & & .. / & & & & .. / ............ Ecole Elщmentaire Jean Paul Marat 3, allщe d Ouessant - 38130 Echirolles Tщlщphone : 04 76 09 04 26 Fiche de renseignements 2004-2005 Nom de l enfant : Prщnom : Nщ(e) le : .......... / .......... / ................. Lieu de naissance : Nationalitщ : ..................................................... Sexe : M F Adresse : N░ : Rue : Code postal : Ville : Tщlщphone domicile : & & & & .. / & & & & .. / & & & & .. / & & & & .. / & & & & .. (entourer ici LR si Liste Rouge) Donnщes mщdicales : F n░ de sщcuritщ sociale couvrant l'enfant : /____/_______/_______/_______/_____________/_____________/ clщ /______/ Les renseignements suivants restent confidentiels : Situation familiale : Cщlibataire Mariщs vie conjointe sщparщs divorcщs veuf(ve) Autoritщ parentale : Rщsidence principale : Conjointe Pшre Mшre Autre Conjointe Pшre Mшre Autre En cas de divorce ou sщparation, merci de fournir une copie de l extrait de jugement. Frшres - SSurs : Nom Prщnom Date de naissance Nom Prщnom Date de naissance 1 ....................................... ............................. ........ / ....... / .............& 4 ...................................... ............................. ........ / ....... / ............. 2 ....................................... ............................. ........ / ....... / .............& 5 ...................................... ............................. ........ / ....... / ............. 3 ....................................... ............................. ........ / ....... / .............& 6 ..............& & & & .& ...... ............................. ........ / ....... / ............. Coordonnщes du mщdecin de famille (pour les cas d urgence) : Nom du Docteur : Adresse du Cabinet : Tщlщphone : & & & & / & & & & / & & & & / & & & & / & & & & Assurance de l щlшve : Nom Sociщtщ ou Mutuelle : N░ Contrat : Adresse du Cabinet : Individuelle accident : OUI NON Dщclarations complщmentaires : Je soussignщ, nom : __________________________________ , prщnom : __________________________ , signale р l'щcole : Des allergies aux mщdicaments : Des recommandations particuliшres : Dщclaration relative aux activitщs pщdagogiques obligatoires : Je suis informщ que mon enfant est tenu de participer aux sorties gratuites prщvues par l'щcole dans le cadre de ses activitщs pщdagogiques dans le temps scolaire. Dщclaration relative au droit р l image : Barrer la mention inutile : J'autorise Je n'autorise pas la publication de photos, d activitщs scolaires uniquement, avec mon enfant, sur le journal papier et sur le site Web de l щcole. Dщclaration relative р l'autorisation de communication de l'adresse personnelle : Barrer la mention inutile : J'autorise Je n'autorise pas la communication de mon adresse personnelle aux associations de parents d'щlшves, telle qu'elle figure dans le registre des щlшves inscrits. date : signature : CP CE1 CE2 CM1 CM2 Cadre rщservщ р la Direction : Date d entrщe р l щcole щlщmentaire Date de sortie de l щcole щlщmentaire ............... / ............... / ....................... ................ / ................ / ......................... Ecole prщcщdente (indispensable et avec prщcision) : щlщmentaire, maternelle, n░ rue code ville Nom de l enfant : Prщnom : Nщ(e) le : .......... / .......... / ................. Lieu de naissance : Nationalitщ : ..................................................... Sexe : M F Fiche d autorisations 2004-2005 Ecole Elщmentaire Jean Paul Marat 3, allщe d Ouessant - 38130 Echirolles Tщlщphone : 04 76 09 04 26 Piшces р joindre pour une nouvelle inscription : - Livret de famille - Carnet de santщ - Attestation d assurance (septembre) - Certificat de radiation de l щcole prщcщdente (si l щlшve arrive d une щcole щlщmentaire) ╔pЩ1TSH    \qЩ1TSHP#D "Ё"$ш$К, 08@hИ`."фр9"0╣(GqЩ1TSH         NON Dщclarations complщmentaires : Je soussignщ, nom : __________________________________ , prщnom : __________________________ , signale р l'щcole : !<Z|кш╢╕║rО╨<"$&ш4\BFH╠Ў( R 8 \ | ╩ D ╥иllllddBиllllddBиlllBllll°ЁтЁ╬"╘Ф4"┬ч4"┬ч" °<2В2'(К( ┐ Є+ . Аю6 `!`!."2В'(К ыЕaЕ<2В2'(К( b╟ Є+ . Аю6 `!`!.*" "GЩ2В'(К `/4."╘Ф2В'(К ▌N ыЕa ЕD И , H ~ PRz|~np╪╠4╝Иz*рz╓╠╚╛╓ЮИrb"и)4""A" "s"╘Ф" "s4"┬ч 2В'(К CЄ ╦6 4"┬ч "8c 4""AJ" "GЩ2В2'(К( ┐ @w . Аї  `!`!.4""AP" "GЩ"╘Ф2В2'(К( ┐ T/ . CЄ 7`7.4""A4""A4" "s2В'(К з\G\.4""AD" "s2В,'(К" Ч!). 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