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["福建幼儿师范高等专科学校"]
["学生学籍信息变更申请表"]
["学 院",null,"专业班级",null,null,"学 号"]
["姓 名",null,"性 别",null,"联系电话"]
["出生年月",null,"家庭地址"]
["原信息"]
["申请变更为"]
["变更原因","\n\n\n\n\n\n\n\n                                                     申请人签字：                                     年    月    日"]
["学院审核","\n\n\n                        　　 院长（签名）：                        （公章）            年    月    日"]
["教务处\n审  批","\n\n\n                          教务处处长（签名）：        　         （公章）             年   月   日"]
["注：本表由申请人填写并附相关证明材料。"]

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