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["西南科技大学网络教育新生报名表"]
["招生批次：","2020年春季","校外学习中心名称:"]
["个人信息部分"]
["姓名",null,"性别",null,"学生照片"]
["出生日期",null,"政治面貌"]
["民族",null,"入学前国民教育最高学历层次"]
["证件类型","身份证","证件号码"]
["录取方式","自主招生录取","就读形式","网络教育"]
["职业状况",null,"所在省份（自治区、直辖市）",null,"联系电话"]
["联系地址",{"$nulls":3},"邮政编码"]
["本人简历         （从高中填起）","起止时间","学习学校或工作单位",null,null,"任职"]
[]
[]
[]
[]
["家庭主要关系","关系","姓名","联系电话","工作单位或联系地址"]
[]
[]
["报考信息部分"]
["报考层次",null,"报考专业"]
["入学前学历毕业证书信息部分"]
["入学前学历学校代码",null,"入学前学历学校名称"]
["入学前学历毕业年份",null,"入学前学历证书编号"]
["个人声明","本人郑重声明：本表所填的个人资料及所附的证明材料均真实有效。若本人所填资料及提供的证明材料（专升本层次的专科〈本科〉毕业证必须是国家承认的国民教育系列的大学专科〈本科〉文凭）有虚假或不实，任何时候审核不通过所造成一切后果，均有本人负责。西南科技大学网络教育学院及其校外学习中心不承担任何责任。"]
[null,null,"声明人签名："]
["                                            校外学习中心（公章）　　                                                                                                                                                    ",null,"                                                                                       网络教育学院网络教育科（公章）"]
[null,"  年　　月　　日",null,null,"    年　　月　　日"]
["备注：1.此表一式两份，一份交网络教育学院，一份留存校外学习中心。"]
["2.请将身份证复印件和前学历毕业证书复印件或毕业证书证明材料粘贴在此表背面。"]

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