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Nr 53 str.

..............................................
(pieczęć podłużna szkoły)

PROTOKÓŁ
EGZAMINU PROMOCYJNEGO
Z .......................................................................

Data egzaminu ............................................................

Ocena
Lp. Imię (imiona) i nazwisko ucznia Treść egzaminu Uwagi
(punkty)

....................................................
1 klasa ...........................................

nauczyciel ...................................

....................................................
2 klasa ...........................................

nauczyciel ...................................

....................................................
3 klasa ...........................................

nauczyciel ...................................

....................................................
4 klasa ...........................................

nauczyciel ...................................

....................................................
5 klasa ...........................................

nauczyciel ...................................

CZŁONKOWIE PRZEWODNICZĄCY
KOMISJI EGZAMINACYJNEJ KOMISJI EGZAMINACYJNEJ

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

ART-II/274/3

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