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["辽宁理工学院学生休学审批表"]
["202    第              号"]
["所在学院",null,"姓  名",null,"性  别",null,"学     制"]
["学   号",null,null,"休学至复学时间",null,null,"专业/班级"]
["身份证号",null,null,"家庭住址"]
["本\n人\n申\n请"]
[{"$nulls":5},"学生本人签字："]
[{"$nulls":5},"学生家长签字："]
[{"$nulls":5},"家长电话："]
[{"$nulls":5},"年    月     日"]
["学院意见","         根据《辽宁理工学院学生管理规定》中第     章第      条第      款之规定：\n\n\n\n\n同意        同学休学申请。"]
[]
[{"$nulls":3},"院长签字：",null,"\n副院长签字："]
[{"$nulls":5},"公   章："]
[{"$nulls":5},"年   月    日"]
["学生处意见"]
[]
[{"$nulls":5},"处长签字："]
[{"$nulls":5},"公章："]
[{"$nulls":5},"年   月   日"]
["教务处意见"]
[]
[{"$nulls":5},"处长签字："]
[{"$nulls":5},"公章："]
[{"$nulls":5},"年   月   日"]
["学校领导审批"]
[]
[]
[{"$nulls":5},"主管校长签字："]
[{"$nulls":5},"年   月   日"]
["备注：1、因病申请休学的学生，需另附学校指定或三甲等级以上医院的诊断证明 。\n            2、此表一式五份，学生处、财务处、教务处、学生所在学院及学生本人各一份。\n     3、休学学生须在休学期满前一周内提出复学申请，逾期不办理相关手续者，按照学院有关规定处理。"]