CNG HA X HI CH NGHA VIT NAM

c lp - T do - Hnh phc
nh 4 x 6

N XIN CP HC BNG

Knh gi: ..................................................................................................................

....................................................................................................................................
- H v tn hc sinh: .......................................................................................
- Ngy thng nm sinh: ...................................................................................
- Ni sinh:........................................................................................................
- Ni hin ti: ...............................................................................................
- Hin dang hc lp:........................................................................................
- Trng:..........................................................................................................
- Hnh kim: ...................................................................................................
- Hc lc:.........................................................................................................
- H v tn cha:................................................................................................
- Ngh nghip:.................................................................................................
- H v tn m:.................................................................................................
- Ngh nghip:.................................................................................................
- Hon cnh gia nh:.......................................................................................
Nay ti lm n ny gi n ....................................................................... xem
xt chp nhn cho ti c hc bng .
Trn trng cm n!
Ngy
thng
nm 2010
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