Planting Wisdom Seed Scholarship Fund

Dn nh
3x4cm

H S NGH XT CP HC
BNG
Knh gi: Qu hc bng m Mm Tr Tu

I. THNG TIN C NHN:

1. H v tn: .................................................. Ngy sinh:.................. Gii tnh: .............
2. H khu thng tr: ....................................................................................................
3. Sinh vin trng: ....................................... Khoa: ..................... MSSV: .....................
4. S CMND: ................................ Ngy cp: ......................... Ni cp: ..........................
5. Dn tc: ..................................................... Tn gio: ..................................................
6. a ch tm tr: ............................................................................................................
7. in thoi: ....................................... Email: ................................................................
8. Bn nhn c hc bng no khc cha

Khng

Nu c, bn hy ghi r tn v nm nhn hc bng: ........................................................

Tr gi ca hc bng : ..................................................................................................
II. QUAN H GIA NH:
1. H tn cha: ................................................................ Sinh nm: .................................
a ch thng tr: ..........................................................................................................
Ngh nghip: ................................................................in thoi:.................................
2. H tn m: ................................................................ Sinh nm: .................................
a ch thng tr: ..........................................................................................................
Ngh nghip: ......................................................................in thoi: ..........................

3. Anh ch em rut:
H tn

Sinh nm

Ngh nghip

Ni cng tc/hc tp

III. YU CU:
Hy vit mt bi lun nu l do xin hc bng, hc bng ny c th gip g cho bn
trong vic thc hin nhng d nh, c m.
Gi :
Trnh by vn tt hon cnh gia nh.
Cc n lc vt kh trong hc tp v cuc sng.
Mc tiu ca cuc i bn.
Bn s lm g t c mc tiu ?
Nu nhn c hc bng, bn s s dng n nh th no?
(Bi lun ca bn c th vit tay hoc nh my v nh km theo t n ny.)
Ti xin cam kt nhng thng tin nu trong n ny l ng s tht. Trong trng hp
pht hin s khng chnh xc, ti xin hon ton chu mi trch nhim v cc vn
pht sinh.
Trn trng knh cho!
..................ngy.....thng.....nm 2014
Ngi lm n
(k & ghi r h tn)

......................................

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