CNG HA X HI CH NGHA VIT NAM

c lp T do Hnh phc
-------------------------

BN NG K THAM GIA CUC THI

N sinh thanh lch i hc Quc gia H Ni ln IV i s VNU 2015
Knh gi: Ban T chc cuc thi
Tn ti l: ....Tn gi khc :...
Lp: .. Khoa:............
Trng
Ngy sinh:. ..Qu qun:..
Ch hin nay: .....
Chiu cao: .cm; Cn nng:..kg; Vng 1:....cm; Vng 2:cm; Vng 3:...cm
S in thoi:..........E-mail:.......
im tng kt ca hc k gn nht:
Chc v (on TN, Hi SV, lp, CLB nu c): .......
........
tham gia Cu lc b (t/i/nhm nu c): ..

Cc gii thng, bng khen, giy khen, danh hiu (nu c):

tng tham gia cc hot ng no ca on Thanh nin/Hi Sinh vin...........................................

...
..
.......
Mt vi iu v bn thn:
- S trng/nng khiu/ kh nng ca bn thn: ..

........
- S thch: ......
...
.....

- iu khng thch nht bn thn: .................

...
............................................................................................................................................................
.....
- Thnh cng ln nht t c: ......

- M c trong tng lai: ..

....
- Cu ni yu thch nht ...............................................................
...........
- Thn tng:.........................................................................................................................................
- Mt vi thng tin c nhn khc: .....
....
....
Mt vi iu v cuc thi:
- L do tham d cuc thi: ..........
...
.iu
mong
i
nht

cuc
thi
ny:...........
....................
............
- Nu l thnh vin Ban Gim kho, bn s t cu hi g cho phn thi ng x?

- Nu c gi mt thng ip ti hc sinh, sinh vin ton HQGHN trn sn khu m chung kt

cuc thi ny, bn s gi thng ip g: .
....
....

Ti tm hiu y cc quy nh ca cuc thi v cam kt nghim tc thc hin cc ni

dung sau y:
1. Thc hin nghim tc Th l ca cuc thi v chp hnh mi quy nh ca Ban T chc
Cuc thi N sinh thanh lch HQGHN ln IV i s VNU 2015.
2. Khng b cuc thi gia chng v tham gia y cc bui tp, cc chng trnh d ngoi
cng nh cc ni dung ca cuc thi.
3. Trung thc trong khai bo cc thng tin c nhn.
Sau khi nghin cu k hoch v th l ca cuc thi N sinh thanh lch HQGHN ln IV, ti
xin ng k tham gia cuc thi v ng chp hnh nghim chnh quy nh ca Ban T chc. Ti
cam oan nhng li khai trn l ng s tht v xin hon ton chu trch nhim.
H Ni, ngy
Xc nhn ca on Thanh nin/Hi Sinh
vin Trng/Khoa

thng

Ngi ng k
(K v ghi r h tn)

nm 20

Lu : Thi gian np h s t ngy 01/12/2014 n ngy 01/01/2015 ti Vn phng on TN Hi SV

HQGHN (P.605 Nh iu hnh HQGHN, 144 Xun Thy, Cu Giy, HN). Cc th sinh lu gi 4
nh (trong c 1 nh chn dung, 3 nh ton thn). File mm ca nh v h s gi vo a ch
daisuvnu2015@gmail.com.