TRNG I HC SI GN

KHOA..

CNG HA X HI CH NGHA VIT NAM

c lp T do Hnh phc

N XIN I HC
Knh gi:

Hiu trng trng i hc Si Gn;

Trng phng T chc Cn b.
Trng khoa, n v..

Ti tn l: ................................................................................ Nam/N: ............

Sinh ngy ........ thng .......nm......... Ni sinh: ..................................................
in thoi lin lc:....................................................
Ti tham gia cng tc ti Trng i hc Si Gn t ngy......... / .... / .........
Cng vic m nhim: ........................................................................................
Nay ti lm n ny xin c i hc tp nng cao trnh ti trng .............
(c giy bo nhp hc km theo).
Thi gian hc......nm.
Chuyn ngnh :. ..............
Nu c chp nhn, ti cam kt thc hin tt cc cng vic c giao v hon
thnh hc kha hc theo ng thi gian quy nh.
Tp.H Ch Minh, ngy .. thng nm ...
Ngi lm n

kin ca Trng n v

kin ca Trng phng TCCB

Duyt ca Hiu trng

Ngy ....../ .... / ........