MU 2

THNH ON TP. H CH MINH

ON TNCS H CH MINH
BCH ON TRNG H BCH KHOA
***
M phiu: MT12TN_51201097_2014

PHIU THNG TIN ON VIN NM HC 2013 - 2014

I. THNG TIN C NHN
1. H v tn (ch IN HOA): NGUYN KIM TRUNG HIU
2. MSSV/MSCB: 51201097........................... 3. Chi on: MT12TN.......................
4. Ngy thng nm sinh: 27/04/1994.............. 5. Gii tnh: NAM.............................
6. Dn tc: Kinh............. 7. Tn gio: Thin Cha 8. CMND:272390896................
9. Qu qun (x, huyn, tnh/tng ng): Cam Ha, Cam Ranh, Khnh Ha........
.....................................................................................................................................
10. H khu thng tr (x, huyn, tnh/tng ng): Xun Bc, Xun Lc, ng
Nai...............................................................................................................................
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11. a ch tm tr: K tc X i hc Bch Khoa, 497 Ha Ho, F. 7, Q. 10, Tp.
HCM............................................................................................................................
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12. Email: nguyenkim94er@gmail.com......... 13. in thoi: 01657530556............
II. THNG TIN ON V
14. Ngy vo on: 15/10/2009..................... 15. Ni vo on: THPT iu Ci. . .
16. Tnh trng on tch (nh x vo nu c):
S on vin

Nu cn, ni lu tr l:
on khoa
T bo qun
Khc: .

Th on vin

Nu cn, ni lu tr l:
on khoa
T bo qun

 Khc: .

Ngh quyt kt np on vin

Nu cn, ni lu tr l:

(Ngh quyt ri)

on khoa
T bo qun
Khc: .

Mt ton b on tch

17. Ngy vo Hi Sinh vin Vit Nam: 2012..............................................................

18. Tham gia lp bi dng nhn thc v ng: C Khng.
Nu c, ghi r kt qu: ............................. nm..........................................................
19. Ngy vo ng (d b): ..................... 20. Ngy vo ng (chnh thc): ..........
21. Chc v ng, on, Hi hin ti: ......................................................................
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XC NHN CA CHI ON
TM. CHI ON
B TH

TP. H Ch Minh, ngy25thng04 nm 2014

Ngi thc hin
(k v ghi r h tn)

Lm Minh Phng

Nguyn Kim Trung Hiu