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ﺧــﺎﺹ ﺑﺎﻟﻤﺘﻌﻠــــﻢ
NOM : ZAHAFI ﺍﻟﻠﻘﺐ :ﺯﺣﺎﻓﻲ
PRENOM : MAROUA ﺍﻹﺳﻢ :ﻣﺮﻭﻯ
ﺍﻟﻬﺎﺗﻒ 0550364146 : ﺗﺎﺭﻳﺦ ﻭ ﻣﻜﺎﻥ ﺍﻟﻤﻴﻼﺩ 2001-01-04 :ﺑــ :ﺭﻭﻳﺒﺔ ﺍﻟﺠﺰﺍﺋﺮ
ﺍﻟﻌﻨﻮﺍﻥ :ﺣﻲ 130ﻣﺴﻜﻦ ﻉ ﺡ 2ﺭﻗﻢ 13ﺑﺎﺏ ﺍﻟﺠﺰﺍﺋﺮ ﺍﻟﺒﻠﻴﺪ ﺓ
ﺍﻟﻮﻻﻳﺔ -ﺍﻟﺪﺍﺋﺮﺓ -ﺍﻟﺒﻠﺪﻳـــﺔ :ﺍﻟﺒﻠﻴﺪﺓ -ﺍﻟﺒﻠﻴﺪﺓ -ﺍﻟﺒﻠﻴﺪﺓ
ﻧﻮﻉ ﺍﻟﺪﺭﻭﺱ :ﺃﺭﺿﻴﺔ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻹﻟﻜﺘﺮﻭﻧﻴ)ﻠﻠﺠﺪﺩ( ﺍﻟﻤﺴﺘﻮﻯ ﻭ ﺍﻟﺸﻌﺒﺔ :ﺛﺎﻟﺜﺔ ﺛﺎﻧﻮﻱ ﻟﻐﺎﺕ ﺃﺟﻨﺒﻴﺔ ﺃﻟﻤﺎﻧﻴﺔ 318
ﺍﻟﺒﻜﺎﻟﻮﺭﻳﺎ /ﺷ.ﺘ.ﻢ :ﻧﻌﻢ ﻧﻮﻉ ﺍﻟﻄﺎﻟﺐ :ﻣﺘﻌﻠﻢ ﻋﺎﺩﻱ ﻫﻞ ﺃﻧﺖ ﻣﺴﺠﻞ ﺑﺜﺎﻧﻮﻳﺔ ﺃﻭ ﻣﺘﻮﺳﻄﺔ :ﻻ
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ﻣﻼﺣﻈﺔ:
ﺗﺼﺮﻳﺢ ﺷﺮﻓﻲ ﻳﻤﻀﻰ ﻣﻦ ﻃﺮﻑ ﺍﻟﻤﻌﻨﻲ ﻭ ﻳﺼﺎﺩﻕ ﻋﻠﻴﻪ ﻓﻲ ﺍﻟﺒﻠﺪﻳﺔ ،ﻭ ﻳﻘﺺ ﻭ ﻳﻮﺩﻉ ﻓﻲ ﺍﻟﻤﺮﻛﺰ ﺍﻟﻮﻻﺋﻲ ﻣﻊ ﻣﻠﻒ ﺍﻟﺘﺴﺠﻴﻞ.
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ﺗﺼﺮﻳﺢ ﺷﺮﻓﻲ
ﺃﻧﺎ ﺍﻟﻤﻤﻀﻲ ﺃﺳﻔﻠﻪ ﺍﻟﻤﺘﻌﻠﻢ :ﺯﺣﺎﻓﻲ ﻣﺮﻭﻯ ﺑﺘﺎﺭﻳﺦ 2001-01-04ﺏ ﺭﻭﻳﺒﺔ ﺍﻟﺠﺰﺍﺋﺮ
ﺃﺻﺮﺡ ﺑﺸﺮﻓﻲ ﺑﺄﻧﻨﻲ ﻗﺪ ﺃﻃﻠﻌﺖ ﻋﻠﻰ ﺑﻨﻮﺩ ﺍﻟﻨﻈﺎﻡ ﺍﻟﺪﺍﺧﻠﻲ ﻟﻤﺘﻌﻠﻤﻲ ﺍﻟﺪﻳﻮﺍﻥ ﺍﻟﻮﻃﻨﻲ ﻟﻠﺘﻌﻠﻴﻢ ﻭ ﺍﻟﺘﻜﻮﻳﻦ ﻋﻦ ﺑﻌﺪ ﺍﻟﺼﺎﺩﺭ ﻓﻲ ﺍﻟﺴﻨﺔ
ﺍﻟﺪﺭﺍﺳﻴﺔ ) 2021/2020ﻧﻮﻓﻤﺒﺮ (2020ﻭ ﺃﻟﺘﺰﻡ ﺑﺘﻄﺒﻴﻖ ﻣﺎ ﻭﺭﺩ ﻓﻴﻪ ﻣﻦ ﺗﻌﻠﻴﻤﺎﺕ ﻭ ﺗﻮﺟﻴﻬﺎﺕ
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ﻓـﻲ ﺇﻃـﺎﺭ ﺍﻹﺟﺮﺍءﺍﺕ ﺍﻟﻘﺎﻧﻮﻧﻴﺔ ﺍﻟﻤﻌﻤﻮﻝ ﺑﻬﺎ ،ﻭﻋﻤﻼ ﺑﺎﻟﻤﻨﺸﻮﺭ ﺭﻗﻢ 444ﺍﻟﻤؤﺭﺥ ﻓﻲ 29ﺟﻮﻳﻠﻴﺔ ، 2000ﻭ ﺍﻟﺼﺎﺩﺭ ﻋﻦ ﻣﺼﺎﻟﺢ ﺭﺋﻴﺲ
ﺍﻟﺤﻜﻮﻣﺔ ،ﺍﻟﻤﺪﻳﺮﻳﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﻮﻇﻴﻒ ﺍﻟﻌﻤﻮﻣﻲ ،ﻭﺍﻟﻤﺘﻌﻠﻖ ﺑﺘﻮﺛﻴﻖ ﺍﻟﻤؤﻫﻼﺕ ﻭﺍﻟﺸﻬﺎﺩﺍﺕ ﻭ ﺣﻔﺎﻇﺎ ﻋﻠﻰ ﻣﺼﺪﺍﻗﻴﺔ ﻣؤﺳﺴﺎﺗﻨﺎ ﺍﻟﺘﺮﺑﻮﻳﺔ
ﻭﺍﻟﺘﻌﻠﻴﻤﻴﺔ ،ﻧﻄﻠﺐ ﻣﻦ ﺳﻴﺎﺩﺗﻜﻢ ﺍﻟﻤﺤﺘﺮﻣﺔ ﺇﻓﺎﺩﺗﻨﺎ ﺑﻤﺪﻯ ﺻﺤﺔ ﺍﻟﺸﻬﺎﺩﺓ ﺍﻟﻤﺪﺭﺳﻴﺔ ﺍﻟﻤﻘﺪﻣﺔ ﻣﻦ ﻃﺮﻑ .
ﺍﻟﻤﺘﻌﻠﻢ )ﺓ( :ﺯﺣﺎﻓﻲ ﻣﺮﻭﻯ
ﺗﺎﺭﻳﺦ ﻭ ﻣﻜﺎﻥ ﺍﻟﻤﻴﻼﺩ 2001-01-04 :ﺑــ :ﺭﻭﻳﺒﺔ ﺍﻟﺠﺰﺍﺋﺮ
ﺍﻟﺴﻨﺔ ﺍﻟﺪﺭﺍﺳﻴﺔ .................................... : ﻣﺴﺠﻞ )ﺓ( ﻓﻲ ﺍﻟﻤﺴﺘﻮﻯ .................................... :
ﺍﺳﻢ ﻭ ﻟﻘﺐ ﻭﺧﺘﻢ ﻭ ﺇﻣﻀﺎﺀ ﻣﺪﻳﺮ )ﺓ( ﺍﻟﻤﺮﻛﺰ ﺍﻟﻮﻻﺋﻲ
ﺍﻟﻤﺘﻌﻠﻢ )ﺓ( ﺍﻟﻤﺬﻛﻮﺭ ﺃﻋﻼﻩ ﻣﺴﺠﻞ )ﺓ( ﺑﺎﻟﺴﺠﻴﻼﺕ ﺍﻟﺮﺳﻤﻴﺔ ﻟﻤؤﺳﺴﺘﻨﺎ ﺗﺤﺖ ﺭﻗﻢ ............... :
ﻟﻠﺴﻨﺔ ﺍﻟﺪﺭﺍﺳﻴﺔ ........................ :ﻭ ﺷﻬﺎﺩﺓ ﺍﻟﻤﺪﺭﺳﻴﺔ ﺻﺎﺩﻗﺔ .
ﺍﻟﻤﺘﻌﻠﻢ )ﺓ( ﺍﻟﻤﺬﻛﻮﺭ ﺃﻋﻼﻩ ﻏﻴﺮ ﻣﺴﺠﻞ )ﺓ( ﺑﺎﻟﺴﺠﻴﻼﺕ ﺍﻟﺮﺳﻤﻴﺔ ﻟﻤؤﺳﺴﺘﻨﺎ ﻭ ﺷﻬﺎﺩﺓ ﻣﺪﺭﺳﻴﺔ ﻏﻴﺮ ﺻﺎﺩﻗﺔ