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112學年度補校入學報名表
紅色*號請詳細填寫
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姓名
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身分別
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新生
轉學生(二-三年級)
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學歷
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請填寫國小畢業學校及最高畢業學歷
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身分證或居留證號碼
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依個人資料保護法規定告知,此資訊僅供報名使用,不另作他用
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出生出生年月日
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MM
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DD
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YYYY
連絡電話
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通訊地址
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