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["        长江大学成人高等教育本科毕业生学士学位申请与审批表"]
[]
["姓　名*",{"$nulls":3},"性　别*",null,null,"照片*"]
["民　族*",{"$nulls":3},"政治面貌*"]
["身份证号*",{"$nulls":3},"所属站点*"]
["成考录取\n省份*",{"$nulls":3},"联系电话*"]
["学习形式*",null,"学　制*",null,"专　业*"]
["入学时间*","             ",null,null,"毕业时间*","           "]
["申请学士学位课程考试成绩","学位外国语成绩*",null,"科目",null,null,"学位课程平均成绩*"]
[{"$nulls":3},"分数"]
[null,"学位课程成绩*           (必须填写科目和分数）",null,"课程名称"]
[{"$nulls":3},"分数"]
["在校期间何时因何原因受过何种奖励处分"]
["教学站（点）审查意见*"]
[{"$nulls":5},"　　　　　　　　　（公章）"]
[{"$nulls":5},"                    年      月      日"]
["院成人本科学士学位审核工作组审核意见"]
[{"$nulls":5},"　　　　　　　　　（公章）"]
[{"$nulls":5},"                    年      月      日"]
["校学位评审委员会评审意见"]
[]
[]
[]
["注：1、此表*号部分必须填写。"]
["    2、学习形式分为函授、业余、自考这三种学习形式。"]
["    3、教学站（点）审查意见，函授和业余的学生由各教学函授站审查，自考学生由各助学机构教学点审查。"]