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["     艺术学院    年贫困家庭学生困难补助申请表"]
["                                                              填表日期：年   月   日           "]
["姓  名",null,"性别",null,"民族",null,"班级"]
["家庭详细地址"]
["父母职业及联系方式"]
["是否申请助学贷款",{"$nulls":6},"申请得到的贷款总金额"]
["欠交学费、住宿费情况"]
["本学年已获得的贫困生奖学金等级或临时困难补助次数和金额"]
["违纪、留级或考试不及格科目、吸烟、嗜酒、进网吧及使用移动电话等情况说明"," "]
["申请特困补助理由：                                          申请补助标准："]
{"$rows_empty":9}
["班委会和班主任意见："]
[]
[]
[]
[]
[]
["班长签字：                             班主任签字：                  时间：年    月    日        "]
["学院意见："]
[]
[]
[]
[]
[]
["                        主管领导签字：",{"$nulls":7},"   2010年   月   日"]
["备  注(填写建设银行卡号)："]

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