Ph lc 1: Mu n ng k d thi

I HC QUC GIA H NI
TRNG I HC NGOI NG

S :
nh 3 x 4

/TB-T

CNG HO X HI CH NGHA VIT NAM

c lp - T do - Hnh phc
H Ni, ngy ... thng ... nm .......

PHIU NG K D THI
K THI NH GI NNG LC TING ANH

H v tn:......................................................... Nam / N: ..................

Ngy sinh:.......................................... Ni sinh: ...................................................
S CMND: ........................................
Cp ngy: .......................................... Ni cp: ....................................................
Trng/Khoa: ......................................................................................................
Kha hc: ................................................. M sinh vin: ..................................
Email: ...................................................................................................................
in thoi: ............................................................................................................
a ch lin h: .....................................................................................................
ng k tham d k thi ngy: ................................................................................
NGI NP N
(K v ghi r h tn)

................................................................................................................................................

XC NHN NP N D THI
Ngy .......... thng ......... nm 20......

Khoa Ting Anh-Trng HNN nhn

ca: ........................................................................... L sinh vin kha

...............Trng: .. S h s:
............/GNLTA
NGI NHN N