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秀山國小午餐退費申請表
申請午餐退費於請假前一日下午2點前，請學生或家長至學務處登記或撥打電話(29434353分機825)，或填寫本申請表辦理退費。逾時不候。
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學生班級座號 (例：6年1班1號就填「60101」)
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Your answer
學生姓名
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Your answer
連續停餐區間 (例：要連續停餐一個星期，就填寫○月○日-○月○日)
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非連續停餐日期 (例：要停非連續某幾天的餐，就填寫要停餐的日期○月○日)
*連續停餐區間及非連續停餐日期請選擇1項填寫
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申請退費停餐(天)數
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退費事由
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請假
轉學
補助
退出課後班
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聯絡人姓名
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聯絡人電話
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