Mau Phu Luc Cua Thong Tu 10
description
Transcript of Mau Phu Luc Cua Thong Tu 10
-
Ph lc
(Ban hnh km theo Thng t s 10/2014/TT-BGDT ngy 11/4/2014 ca B trng B Gio dc v o to)
Mu s 01: Bo co tin hc tp
Mu s 02: n xin chuyn nc/trng/ngnh hc
Mu s 03: n xin gia hn thi gian hc tp nc ngoi
Mu s 04: Bo co tt nghip
Mu s 05: n xin chuyn t trng hc nc ngoi v hc ti Vit Nam
Mu s 06: Bo co thnh tch ca c nhn lu hc sinh
Mu s 07: Bo co v vic tuyn sinh v c cng dn Vit Nam ra nc ngoi hc tp
Mu s 08: Thng k s lng cng dn Vit Nam c c ra nc ngoi hc tp
Mu s 09: Thng k danh sch cng dn Vit Nam c c ra nc ngoi hc tp.
-
2
Mu s 01 CNG HA X HI CH NGHA VIT NAM
c lp - T do - Hnh phc
BO CO TIN HC TP
(t ngy ... thng ... nm ............ n ngy ... thng ... nm............)
Knh gi: ....................................................1
1. H v tn: ....................................................... Nam/n: ..................................................
2. Ngy sinh: ......................................................................................................................
3. Dn tc: .......................................................... Tn gio: .................................................
4. Nm trng tuyn (i vi lu hc sinh hc bng):. Nm i hc: ..................
5. a ch ni ti Vit Nam: .............................................................................................
6. C quan cng tc (nu c): ..............................................................................................
............................................................................................................................................
7. Din hc bng (Hip nh/NSNN/Khc, ghi c th):................................................... ......
8. Ngnh hc nc ngoi (ghi ting Vit v ting Anh):
............................................................................................................................................
............................................................................................................................................
9. Tn v a ch trng hc nc ngoi (ghi ting Vit v ting Anh): ...........................
............................................................................................................................................
............................................................................................................................................
10. Ngy n trng nhp hc: ............................................................................................
11. Ngy bt u kha hc (theo thng bo ca trng): .....................................................
12. Thi gian o to (theo thng bo ca trng): .............................................................
13. ang hc hc k my, thi gian cn li: ........................................................................
14. a ch ni nc ngoi: .............................................................................................
15. E-mail nc ngoi: .....................................................................................................
16. in thoi lin h nc ngoi: ....................................................................................
17. Kt qu hc tp 2: .........................................................................................................
(Vit theo xp loi, nu c; hoc s mn t im A, im B, im C... hoc theo cch cho im ca trng n hc; i vi nghin cu sinh, thc tp sinh ghi xp loi kt qu): ...................................................................................................................................
............................................................................................................................................
............................................................................................................................................
18. H tn ngi hng dn (supervisor) hoc ngi t vn (adviser): ...............................
a ch e-mail ca ngi hng dn/t vn: .......................................................................
1 Tn c quan c i hc. 2 i vi lu hc sinh hc bng: Ghi thng tin y lm cn c tip tc hoc tm dng cp sinh hot
ph.
-
3
19. Kin ngh, xut (nu c): ...........................................................................................
............................................................................................................................................
20. ngh cp hc ph, sinh hot ph (i vi lu hc sinh hc bng): ..............................
ngh chuyn hc ph (theo giy bo ca trng) lu hc sinh cp nht thng tin ti khon ca trng theo chi tit sau:
- Tn ngn hng
- a ch ngn hng - M s ngn hng (nh
Swift, Code, hoc ABA/Routing)
- Thng tin ngn hng
trung gian (nu c)
- Tn ngi hng (tn ch ti khon ca c s gio dc) - a ch ngi hng
- S ti khon - S Iban (nu c)
nhn sinh hot ph n ht thng ...... nm ......
Hc k cui cng xin c chuyn sinh hot ph n thng........ nm ......., Tng s ...... thng.
Cp nht s ti khon c nhn ng k: 3
- Tn ngn hng
- a ch ngn hng - M s ngn hng (nh
Swift, Code hoc ABA/ Routing)
- Thng tin ngn hng
trung gian (nu c)
- Tn ngi hng (tn ch ti khon c nhn)
- a ch ngi hng
- S ti khon - S Iban (nu c)
Xc nhn ca c s gio dc 4 ., ngy thng nm
Ngi bo co
(K v ghi r h tn)
3 Ghi tn ngi hng theo tn ti khon m ti ngn hng v a ch ngn hng. Lu hc sinh chu mi chi ph
lin quan trong trng hp cung cp thng tin chuyn tin khng chnh xc. 4 nhn c xc nhn ca c s gio dc nc ngoi LHS c th vit bo co bng ting Anh (bo co di
hn 01 trang th cn c ch k/du gip lai xc nhn trn tt c cc trang ca bo co). Nu khng c xc nhn ca c s gio dc trn bo co th phi gi km theo kt qu hc tp c xc nhn ca c s gio dc.
-
4
Mu s 02
CNG HA X HI CH NGHA VIT NAM
c lp - T do - Hnh phc
N XIN CHUYN NC/TRNG/NGNH HC
Knh gi: ..........................................1
Ti tn l: .........................................................................................................................
C quan ch qun: ............................................................................................................
..........................................................................................................................................
c c i hc nc ngoi theo Quyt nh s . ngy . thng ..... nm. ca..............................................................................................................
C s gio dc tip nhn/ang hc: ..............................................................................
Trnh o to: ..............................................................................................................
Khoa: .............................................................. Chuyn ngnh: .........................................
..........................................................................................................................................
Tng thi gian o to theo Quyt nh c i hc/ Vn bn tip nhn o to: ..................
..........................................................................................................................................
Ngy nhp hc: .................................................................................................................
Kt qu hc tp n thi im hin ti: .............................................................................
Ni dung xin chuyn nc/trng/ngnh hc: ...................................................................
..........................................................................................................................................
Vn bn ng tip nhn/i ngnh hc s........ ngy ..... thng .... nm ca ...................
..........................................................................................................................................
L do xin chuyn nc/trng/ngnh hc: ........................................................................
..........................................................................................................................................
..........................................................................................................................................
Ti cam kt t tc mi chi ph pht sinh t vic xin chuyn nc/trng/ngnh hc vt mc quy nh i vi vic i hc theo Quyt nh c i hc ti c s gio dc ban u.
Trn trng ngh Qu c quan xem xt, cho ti c chuyn nc/trng/ngnh hc.
a ch lin lc ca ti: ..............................................................................................
..................................................................................................................................
E-mail: .....................................................................................................................
in thoi nh: ...................................... in thoi di ng: ..................................
..........., ngy ... thng ... nm .........
Ngi lm n
(K v ghi r h tn)
1 Tn c quan c i hc
-
5
Mu s 03
CNG HA X HI CH NGHA VIT NAM
c lp - T do - Hnh phc
N XIN GIA HN THI GIAN HC TP NC NGOI
Knh gi: ..........................................1
Ti tn l: .........................................................................................................................
C quan ch qun: ............................................................................................................
..........................................................................................................................................
c c i hc nc ngoi theo Quyt nh s . ngy . thng ..... nm ca ...........
Tn trng n hc, nc: ................................................................................................
Trnh o to: ..............................................................................................................
Khoa: .............................................................. Chuyn ngnh: .........................................
Tng thi gian o to theo Quyt nh c i hc/ Vn bn tip nhn o to: .................
Ngy nhp hc: .................................................................................................................
L do xin gia hn: .............................................................................................................
..........................................................................................................................................
..........................................................................................................................................
..........................................................................................................................................
..........................................................................................................................................
Thi gian xin gia hn : t thng ....../nm 20...... n thng ...../nm 20....
Kinh ph trong thi gian gia hn: 2 ....................................................................................
..........................................................................................................................................
Trn trng ngh Qu c quan xem xt, cho ti c gia hn thi gian hc tp.
a ch lin lc ca ti: ..............................................................................................
..................................................................................................................................
E-mail: .....................................................................................................................
in thoi nh: ...................................... in thoi di ng: ..................................
..........., ngy ... thng ... nm ......... Ngi lm n
(K v ghi r h tn)
1 Tn c quan c i hc. 2 Ghi r kinh ph do lu hc sinh t thu xp hoc c s gio dc nc ngoi i th.
-
6
Mu 04
CNG HA X HI CH NGHA VIT NAM
c lp - T do - Hnh phc
BO CO TT NGHIP
Knh gi: ................................1
1. H v tn: .....................................................................................................................
2. Ngy sinh: ....................................................................................................................
3. C quan ch qun: ........................................................................................................
4. a ch c tr .................................................................................................................
5. Quyt nh c i hc s .ngy .... thng .... nm .... ca .....................................
6. Thi gian hc tp nc ngoi: ....................................................................................
7. Thi gian gia hn hc tp nc ngoi: t thng / 20. n thng /20 .................
8. Ngy tt nghip: ...................................................... Ngy v nc: ............................
9. Kt qu hc tp 2:
- Vn bng c cp: ....................................................................................................
- Kt qu xp loi hc tp: ............................................................................................
10. Tn c s gio dc nc ngoi (ghi bng ting Vit v ting Anh): ............................
..........................................................................................................................................
11. Tn ti lun vn thc s (nu hc thc s coursework khng c lun vn th ghi: khng c lun vn), ti lun n tin s, chuyn thc tp: ..........................................
..........................................................................................................................................
..........................................................................................................................................
12. Tn v hc hm, hc v ca ngi hng dn: ............................................................
13. nh gi ca c s gio dc hoc gio s hng dn (nu c, vit tm tt): ...............
..........................................................................................................................................
..........................................................................................................................................
14. T nh gi kt qu hc tp, nghin cu: ....................................................................
..........................................................................................................................................
..................................................................................... ....................................................
15. Nguyn vng, ngh 3 : .............................................................................................
..........................................................................................................................................
..........................................................................................................................................
16. C quan cng tc sau khi tt nghip v Vit Nam: ......................................................
..........................................................................................................................................
a ch: .............................................................................................................................
1 Tn c quan c i hc.
2 Ghi r vn bng c cp (thng tin ny bt buc phi c), nu cha c bng tt nghip th phi trnh by r l do;
ghi r kt qu xp loi hc tp (nu c); hoc s mn t im A, im B, C, hoc theo cch cho im ca c s
gio dc. 3 Ghi r: Tr li c quan c hoc b tr ni lm vic hoc cng vic mi ph hp hn vi kt qu c o to;
ng thi nu r vn hoc cng trnh kin ngh c ng dng, kh nng ng dng, yu cu c hc tp bi
dng thm, yu cu v iu kin lm vic trong nc,
-
7
17. a ch lin h 4 : ........................................................................................................
in thoi c nh: .......................................... , in thoi di ng: ...............................
E-mail: ..............................................................................................................................
18. Kin ngh, xut i vi cc c quan ch qun, c quan c i hc: ..........................
..........................................................................................................................................
..........................................................................................................................................
Ti cam oan ni dung bo co l hon ton trung thc, chnh xc v xin chu trch nhim v ni dung bo co.
, ngy thng nm ...
Ngi bo co
(K v ghi r h tn)
4 Thng tin bt buc phi cung cp.
-
8
Mu s 05
CNG HA X HI CH NGHA VIT NAM
c lp - T do - Hnh phc
N XIN CHUYN T TRNG HC NC NGOI V HC TI VIT NAM
Knh gi: Trng/Hc vin1
Ti tn l: ......................................................... Nam/n: ...............................................
Ngy sinh: ........................................................................................................................
c c i hc nc ngoi theo Quyt nh (nu c) s ............. ngy ...... thng ... nm .. ca 2 .................. ...............................................................
Tn trng n hc: ................................................... ........................................................
Trnh o to: ............................. ..................................................................................
Khoa: ........................................................... Chuyn ngnh: ............................................
Tng thi gian o to theo Quyt nh c i hc/Vn bn tip nhn: ...............................
Ngy nhp hc: ..................................................................................................................
L do xin chuyn t trng nc ngoi v hc tp Vit Nam: ...........................................
..........................................................................................................................................
..........................................................................................................................................
..........................................................................................................................................
..........................................................................................................................................
Trn trng ngh Trng/Hc vin .................................................................................
. xem xt, cho ti c chuyn v Qu trng tip tc hc tp.
a ch lin lc ca ti: ..............................................................................................
..................................................................................................................................
E-mail: ......................................................................................................................
in thoi nh: ...................................... in thoi di ng: ...................................
..........., ngy ... thng ... nm ......
Ngi lm n
(K v ghi r h tn)
H s 3 gi km theo gm: 1. 2. 3.
1 Ghi tn c s gio dc m lu hc sinh xin chuyn n tip tc hc tp.
2 i vi lu hc sinh hc bng. 3 Danh mc cc giy t trong H s c quy nh ti im b) khon 3 iu 10 ca Quy ch ny.
-
9
Mu s 06
CNG HA X HI CH NGHA VIT NAM
c lp - T do - Hnh phc
BO CO THNH TCH C NHN LU HC SINH NGH TNG BNG KHEN/GIY KHEN
1
I. S LC L LCH
- H v tn (Ghi y bng ch in thng, khng vit tt): ..................................
- Ngy sinh: ................................................................. Gii tnh: ...........................
- Qu qun: .................................................... ............. ..........................................
- C quan ch qun: ..................................................... ..........................................
- C quan c i hc: ..................................................... ..........................................
- in thoi: ................................................................. E-mail: ..............................
- Chc v (ng, chnh quyn, on th): ...............................................................
- Trnh chuyn mn, nghip v: .........................................................................
- Hc hm, hc v, danh hiu, gii thng: ..............................................................
II. THNH TCH T C 1. Quyn hn, nhim v c giao hoc m nhn: ...............................................................................................................................
...............................................................................................................................
...............................................................................................................................
2. Thnh tch t c ca c nhn: ...............................................................................................................................
...............................................................................................................................
...............................................................................................................................
III. CC HNH THC C KHEN THNG 1. Danh hiu thi ua:
Nm Danh hiu thi ua
S, ngy, thng, nm ca Quyt nh cng nhn danh hiu thi ua; c quan ban hnh Quyt nh
2. Hnh thc khen thng:
Nm Hnh thc khen thng
S, ngy, thng, nm ca Quyt nh khen thng; c quan ban hnh Quyt nh
..........., ngy ... thng ... nm .......
CC O TO VI NC NGOI XC
NHN, NGH (K, ng du)
Ngi bo co (K, ghi r h v tn)
1 ngh ghi r hnh thc ngh khen thng: Bng khen ca B trng B Gio dc v o to hoc Giy khen ca Cc trng Cc o to vi nc ngoi.
-
10
Mu s 07
TN CQ, TC CH QUN 1 TN C QUAN, T CHC 2
S: /BC-..... 3
CNG HA X HI CH NGHA VIT NAM
c lp - T do - Hnh phc
........., ngy ... thng ... nm ......
BO CO
V vic tuyn sinh v c cng dn Vit Nam ra nc ngoi hc tp
Cn c Quyt nh s 05/2013/Q-TTg ngy 15 thng 01 nm 2013 ca Th tng Chnh ph quy nh vic cng dn Vit Nam ra nc ngoi hc tp, Thng t s 10/2014/TT-BGDT ngy 11 thng 4 nm 2014 ca B trng B Gio dc v o to hng dn cng tc qun lu hc sinh Vit Nam hc tp nc ngoi, ........4 bo co v vic tuyn sinh v c cng dn Vit Nam ra nc ngoi hc tp nh sau:
1. Tnh hnh chung v cng tc tuyn sinh v s lng c cng dn Vit Nam ra nc ngoi hc tp 5: ........................................................................................................
..........................................................................................................................................
..........................................................................................................................................
2. Nhng kh khn vng mc:
..........................................................................................................................................
..........................................................................................................................................
..........................................................................................................................................
3. Kin ngh xut:
..........................................................................................................................................
..........................................................................................................................................
..........................................................................................................................................
Trn trng /.
Ni nhn: - ...... ; - ...... ;
- Lu: VT, ...
TH TRNG C QUAN/T CHC
(Ch k, du)
H v tn
Ghi ch: 1 Tn c quan, t chc ch qun trc tip (nu c). 2 Tn c quan, t chc ban hnh vn bn.
3 Ch vit tt tn c quan, t chc hoc chc danh nh nc ban hnh vn bn. 4 Tn c quan/t chc bo co.
5 Km theo bo co chi tit theo Mu s 08 v 09 ti Ph lc ban hnh km theo Quy ch ny.
-
11
Mu s 08 TN CQ, TC CH QUN 1
TN C QUAN, T CHC 2 CNG HA X HI CH NGHA VIT NAM
c lp - T do - Hnh phc
THNG K S LNG CNG DN VIT NAM C C RA NC NGOI HC TP NM .... (*)
(Km theo Bo co s /BC-...... ngy ... thng ... nm ......)
STT Ngnh c i hc3 Nc
Trnh
ang hc
Hon
thnh
kha hc v nc
V nc nhng
khng hon
thnh kha
hc
Ngun kinh ph
4
Ghi ch
Tin s Thc s i hc Cao
ng Bi
dng Khc
Tng s 5:
TH TRNG C QUAN/T CHC
(Ch k, du)
H v tn
Ghi ch: (*) Lp biu trn Microsoft Excel, phng ch Times New Roman, c ch 12 trn cng 1 file gm cc biu khc nhau v gi file vo a ch: [email protected].
1 Tn c quan, t chc ch qun trc tip (nu c). 2 Tn c quan, t chc ban hnh vn bn. 3 Tham kho nhm ngnh hc quy nh ti Quyt nh 38/2009/Q-TTg ngy 09/03/2009 ca Th tng quyt nh ban hnh Bng danh mc gio dc, o to ca h thng gio dc quc dn.
4 Ghi r lu hc sinh i bng ngun kinh ph no: hc bng ngn sch nh nc (NSNN) trung ng hoc a phng, hc bng Hip nh ca nc ngoi cp cho Vit Nam, hc bng ca nc ngoi (HBNN), t tc (TT), 5 Tng s ngi ang hc tp theo tng trnh , ang hc, v nc do c quan c i.
-
12
Mu s 09 TN CQ, TC CH QUN 1
TN C QUAN, T CHC 2 CNG HA X HI CH NGHA VIT NAM
c lp - T do - Hnh phc
THNG K DANH SCH CNG DN VIT NAM C C RA NC NGOI HC TP NM ..... (*)
(Km theo Bo co s /BC-...... ngy ... thng ... nm .......)
STT H v tn Gii tnh
Ngy
sinh
S h chiu
C quan cng tc/ a ch thng tr
Nc n hc
C s gio dc n hc
Trnh o to 3
Ngnh hc 4 Thi gian bt u - Kt thc
Ngun kinh ph
5
Ghi ch
Tng s: ... ngi.
TH TRNG C QUAN/T CHC (Ch k, du)
H v tn
Ghi ch: (*) Lp biu trn Microsoft Excel, phng ch Times New Roman, c ch 12 trn cng 1 file gm cc biu khc nhau v gi file vo a ch: [email protected]. 1 Tn c quan, t chc ch qun trc tip (nu c). 2 Tn c quan, t chc ban hnh vn bn. 3 Ghi r: Tin s (TS), thc s (Ths), i hc (H), cao ng (C), cao ng ngh (CN), trung cp ngh (TCN), trung cp chuyn nghip (TCCN), trung hc ph thng (THPT), trung hc c s
(THCS), tiu hc (TH), thc tp sinh (TTS), bi dng (BD), khc. 4 Tham kho nhm ngnh hc quy nh ti Quyt nh 38/2009/Q-TTg ngy 09/03/2009 ca Th tng quyt nh ban hnh Bng danh mc gio dc, o to ca h thng gio dc quc dn.
5 Ghi r lu hc sinh i bng ngun kinh ph: ngn sch nh nc theo cc n (ghi r s n v d: 322, 911, 165 ), hc bng Hip nh (H), hc bng ca nc ngoi (HBNN), t tc (TT).