Bo co s 1

Knh gi: - B Gio dc & o to

- i s qun Vit Nam ti Vng quc Anh v Bc Ai-len
1. H v tn: (nh ch in)
Nam/N:
2. Ngy thng nm sinh:
3. Dn tc:
Tn gio:
4. a ch ni ti Vit Nam:
in thoi:
5. C quan cng tc gii thiu i hc (nu i hc H hoc chuyn tip t H ln Th.S./
T.S. th ghi: cha cng tc)
6. a ch c quan cng tc ti Vit Nam:
in thoi:
7. B/ C quan ngang B/ Tnh, thnh ph qun l c quan ca LHS:
8. Din hc bng (Hip nh/NSNN/t tc):
9. Trnh c c i hc (tin s, thc s, thc tp sinh, TTS cao cp, i hc, ...)
10. Ngnh hc (ghi tn chuyn ngnh):
11. Tn trng n hc, nc n hc (ghi bng Ting Vit v Ting Anh):
12. Ngy n trng nhp hc:
13. Ngy bt u kha hc (theo thng bo ca trng):
14. Thi gian kha hc (theo thng bo ca trng):
15. ang hc (ngoi ng/chng trnh gii thiu/ kha hc chnh thc):
16. Chuyn ngnh hc thc t ti nc ngoi (ghi bng Ting Vit v Ting Anh):
17. a ch trng n hc:
18. a ch ni ti nc ngoi:
Email:
in thoi:
19. ngh v hc ph, sinh hot ph (nu c):
c nhn SHP tm ng n thng no:
a. S ti khon c nhn ng k (ghi r theo bng sau)
Tn NH
a ch NH
M s NH (Swift Code, ABA.
Routing...)
Thng tin NH trung gian (nu c)

Tn ngi hng
a ch

S ti khon
S Iban (nu c)

b. Hc ph chuyn n trng cha? Nu cha chuyn, ngh cho bit chnh

xc m s ti khon ca trng.
(Thnh ph/ a ht...), ngy ....thng....nm...
Ngi bo co
(k v ghi r h tn)