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客庄國小111學年度畢業生就讀國中意願調查表
苗栗縣教育處來文請國小協助調查112學年度 貴子弟就讀國中之學區調查，以確實掌握入學之動向，並寄發新生報到通知單。請您協助上網填寫相關資料，並於2/20前提交已遷好『欲就讀國中之學區』的『戶口名簿影本』存查。
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班級：六年( )班
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甲
乙
丙
丁
學生班級座號(只填數字)
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Your answer
學生姓名
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Your answer
家長姓名
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Your answer
連絡電話1
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Your answer
連絡電話2
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Your answer
戶籍地址(里、鄰務必要填完整)
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Your answer
畢業生在戶口名簿上的稱謂(例如：長子)
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Your answer
欲就讀國中(目前戶籍所在的國中)
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Your answer
(尚未確定)可能就讀之國中
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