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["附件2                                    "]
["　　清城区扶残助学工程申请表（残疾学生）"]
["姓名",null,null,"性别",null,null,"民族"]
["出生年月",null,null,"户口类别","农业户口  口    非农业户口 口"]
[]
["残疾类别","视力残疾 口    听力残疾 口    言语残疾 口    肢体残疾 口  "]
[null,"精神残疾 口    智力残疾 口    多重残疾 口"]
["家庭地址",{"$nulls":5},"邮政编码"]
[]
["身份证号",{"$nulls":3},"残疾证号",{"$nulls":3},"联系电话"]
[]
["所在\n学校\n(班级\n专业\n",null,null,"学校\n详细\n地址\n",{"$nulls":4},"是否住校",null,"学前教育  口"]
[{"$nulls":10},"义务教育  口"]
[{"$nulls":8},"是口 否口",null,"高中或中专(技)   口"]
[{"$nulls":8},"特教学校口"]
[{"$nulls":10},"大专      口"]
[{"$nulls":8},"普通学校口",null,"本科及以上  口"]
["家\n庭\n主\n要\n成\n员","关  系","姓  名","性别","文化程度","工作单位及职务",{"$nulls":5},"月收入"]
[]
[]
[]
[]
[]
["家\n庭\n经\n济\n情\n况","1、农村贫困线以下  口     2、享受城乡最低生活保障   口    "]
[null,"3、是否已享受同级财政的其他部门助学政策   否口    是口部门名称：                       "]
[null,"4、家庭经济困难(填写申请理由，可另附详细报告)    口"]
[]
[null,"         本人承诺以上情况属实                                申请人：                                    "]
[null,"                    年   月    日"]
["审\n核\n意\n见"]
[]
[]
[null,"              审核人：",{"$nulls":4},"                         审核人："]
[null,"                      镇（街道）残联盖章",{"$nulls":4},"                          学校盖章"]
[null,"                           年   月    日",{"$nulls":4},"                              年    月    日"]
["审\n批\n意\n见","                                                                                                    "]
[null,"                                                                  审核人："]
[null,"                                                                  区残联盖章"]
[null,"                                                                 年     月      日                     "]
[]
["说明：","1、申请人填写本表（申请人为在校残疾学生），要求字迹清楚工整。"]
[null,"2、填写内容真实，凡选择项目，在所选定项“口”内打“√”。"]
[null,"3、本表一式两份，分别由学校、区残疾人联合会所存档备查。"]
[null,"4、申请人向区残疾人联合会递交申请表。"]

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