TRNG I HC THY LI

KHOA CNG NGH THNG TIN

T KHAI THNG TIN SINH VIN

H v tn:Ngy sinh: ........................................

Lp:.in thoi: ........................................

a ch ca gia nh (Ghi chi tit: S nh- ng/ph- Phng- Qun- Thnh

ph hoc i/Thn- Xm X- Huyn- Tnh): ...................................................

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H tn b:..............................................................................................................

Ngh nghip: ..........................................................................................................

in thoi :.............................................................................................................

H tn m: .............................................................................................................

Ngh nghip: ..........................................................................................................

in thoi:..............................................................................................................

H ni, ngy 6 thng 9 nm 2015

Sinh vin
(K, ghi r h tn)