Complexe Scolaire Bellevue, Lubumbashi

Fill the reservation form

1. STUDENT IDENTITY

Last name-last name-First name

Class [2024-2025]

Roll No

Birth Place

Date of birth

Sex

Phone

Spoken languages

Municipality

No., Avenue

Neighborhood

Province of origin

Home district

Home territory

Community of origin

Original village

Native country

2. IDENTITY OF RESPONSIBLE

Father (Full Name)

Phone

Profession

Mother (Full Name)

Phone

Profession

Registration requested by

Phone

Relationship

Email address

3. SOLICITATION [2025 - 2026]

Option & Class

Roll No

4. PREVIOUS STUDIES (School of origin 2024-2025)

Name of the school

Class

(%):

School address

City

Country

Upload document

5. HEALTH

Blood group

Upload photo

I certify on my honor that the information provided above is sincere and true.

"No fees related to registration or re-registration are required at Complexe Scolaire Bellevue Asbl"