Mu 10-QLKH/ HYTCC

BO CO TIN THC HIN TI NCKH/ D N

Thi gian cung cp thng tin: Ngy ......... thng ...... . nm .....
Tn ti/d n
(ting Vit v ting Anh)

Cp qun l: Cp Nh nc / Cp B / Cp C s
(ghi r tn n v qun l)
n v ch tr (Trng hoc c s khc)
(ghi r tn n v ch tr)
Thi gian tin hnh nghin cu/d n (cp nht thng tin)
Bt u: ngy ....... thng ....... nm .......
Kt thc: ngy ....... thng ....... nm .......
a bn tin hnh NC/d n (cp nht thng tin)
Tnh, Huyn, (chi tit)

Thnh vin tham gia ti/d n (cp nht thng tin - Hc hm, hc v, nhim v chuyn mn, thi
gian tham gia cn thit c th, a ch lin h (T/ Email/ Fax)
Ch nhim:
iu phi vin:
Th k:
Gim st vin:
iu tra vin:
Nghin cu vin chnh:
Nghin cu vin:

Mu 10-QLKH/ HYTCC

Tin nghin cu: (nu r l do cha t c ng tin )

cc hot ng c/ cha ctin hnh theo k hoch

cc hot ng kt thc/cha kt thc theo k hoch

cc hot ng c gii ngn/ cha c gii ngn theo k hoch

cc hot ng t/ cha t mc tiu ra

cc hot ng huy ng / khng s cn b cn thit

nh gi s b cc thnh vin tham gia nghin cu: (tng thnh vin)

Tnh cam kt: (Tt, kh, trung bnh, khng t yu cu)

Nng lc: (Tt, kh, trung bnh, khng t yu cu)

Loi b khi ti/ d n (ghi r thnh vin l do)

a thm vo ti/ d n (ghi r thnh vin l do)