I HC QUC GIA TP.

HCM
TRUNG TM I HC PHP

CNG HA X HI CH NGHA VIT NAM

c lp T do Hnh phc

N XIN NGH HC
Knh gi: - B Phn o to Chng trnh ............................................................
- Ging vin B mn .................................................................................

Em tn: ...............................................................Sinh ngy: ..........................................

Hin ang hc lp :..........................................................................................................
Chng trnh:...................................................................................................................
S in thai:...................................................................................................................
Nay em lm n ny knh mong B phn o to v Ging vin B mn cho em
xin ngh hc ngy, c th l ngy: ...
L do: ...
...
Em xin ha s tr li hc tp ng quy nh, s n bi v lm bi y .
Em xin chn thnh cm n.

, ngy ...... thng ...... nm 20..

kin ca Ph trch o to

Knh n
( K v ghi r h tn)