2024 BACK TO SCHOOL FORM - ENSIIE ACCOMMODATION REQUEST FORM - ENSIIE STUDENTS Civility (required) MrMrs Surname Name Nationality date of birth format : dd/mm/yyyy personal email VERY IMPORTANT : We will use this address to communicate essential information to you; You are solely responsible if you ignore them. Make sure you do not block receipt of our emails (spam filter). Personal Phone Family Address Postal-code Town Country GUARANTOR INFORMATIONS Civility (required) MrMme Guarantor Surname Guarantor Name Guarantor Nationality Date of birth format : dd/mm/yyyy VERY IMPORTANTGuarantor personal email : We will use this address to communicate essential information to you; You are solely responsible if you ignore them. Make sure you do not block receipt of our emails (spam filter). Guarantor phone number Guarantor Address Guarantor Postal-Code Guarantor Town Guarantor Country INFORMATIONS ADHESION Your school ENSIIE Arrival date (among the opening days and hours of our offices) Monday to Thursday from 1:30 p.m. to 5:30 p.m. - Friday from 1:30 p.m. to 4:30 p.m. Arrival date format : dd/mm/yyyy Arrival Hour "BANK DETAILS" Country Code * (exemple : FR) Country Controle Code* (exemple : France = 76) Code BBAN * (exemple : establishment code + account + key) Code BIC *: Insert the 11 characters of your BIC or SWIFT CODE (letters and/or numbers) if less than 11 characters, add XXX at the end to reach 11"> COMMITMENT (required) In the event of inaccurate information, admission may be refused; Admission is only effective after signing your membership contract I certify on my honor the accuracy of the information communicated and that I have read the MAISEL SudParis Operating Charter. Δ