REPUBLIKA HRVATSKA

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(naziv i sjedite kole)

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Klasa: __________________ Urbroj: __________________ Matini broj: __________________

PRIJEPIS OCJENA

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(ime i prezime)

OIB

sin/ki ________________________________________________________________
(ime i prezime roditelja)

roen ______________________________ godine, mjesto roenja ___________________________________

(datum)

drava roenja _______________________________ dravljanstvo ___________________________________

upisan___ u _______________________________________________________ u ________________ razred

(vrsta kole - osnovna, gimnazija, strukovna kvalifikacija/zanimanje)

prelazi _______________ u ___________________________________________________________________

(datum) (vrsta kole - osnovna, gimnazija, strukovna kvalifikacija/zanimanje)

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(naziv i sjedite kole)

Temeljem podataka iz razredne knjige u kolskoj godini _____/_____ ueni__ je ocijenjen ___ iz nastavnih
predmeta:

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Izreene pedagoke mjere (l. 83. i 84. Zakona) ____________________________________________________

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Ueni___ je do dana prijelaza izosta___ _________ sati (od toga neopravdano _________ ).

U _______________________________________, ___________________________ 201__ .

Razredni___: Ravnatelj___:
M.P.
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