编辑: 黑豆奇酷 2019-08-30
"东方绿舟――上海市青少年校外活动营地" "素质教育活动联系表" "填表日期:年月日.

"学校名称(盖章)学校分管领导姓名",,

,,

,,

"联系电话",,

,,

,,

"领队姓名",,

,,

,,

"联系电话",,

,,

, 手机号码"手机号码",,

,,

, "学校地址"邮政编码",,

,,

,,

"传真号码",,

,,

, "活动时间",,

" 年月日至 年月日(共天)E-mail" "上车地点"发车时间" "参加活动总人数",,

"总数",,

"男",,

"女",,

"学生人数",,

,"总数",,

"男生",,

"女生",,

"教师人数",,

,"总数",,

"男教师",,

"女教师",,

"少数民族数",,

,,

, ,,

"0",,

"0",,

"0",,

,,

,"0",,

"0",,

"0",,

,,

,"0",,

,,

,,

"外籍人数",,

,,

, "年级/班级",,

"班",,

,"班",,

,"班",,

,"班",,

,"班",,

,"班",,

,"班",,

,"班",,

,"班",,

,"班",,

"性别",,

"男","女","计","男","女","计","男","女","计","男","女","计","男","女","计","男","女","计","男","女","计","男","女","计","男","女","计","男","女","计" "人数",,

,,

"0",,

,"0",,

,"0",,

,"0",,

,"0",,

,"0",,

,"0",,

,"0",,

,"0",,

,"0" "年级/班级",,

"班",,

,"班",,

,"班",,

,"班",,

,"班",,

,"班",,

,"班",,

,"班",,

,"班",,

,"班",,

"性别",,

"男","女","计","男","女","计","男","女","计","男","女","计","男","女","计","男","女","计","男","女","计","男","女","计","男","女","计","男","女","计" "人数",,

,,

"0",,

,"0",,

,"0",,

,"0",,

,"0",,

,"0",,

,"0",,

,"0",,

,"0",,

,"0" "年级/班级",,

"班",,

,"班",,

,"班",,

,"班",,

,"班",,

,"班",,

,"班",,

,"班",,

,"班",,

,"班",,

"性别",,

"男","女","计","男","女","计","男","女","计","男","女","计","男","女","计","男","女","计","男","女","计","男","女","计","男","女","计","男","女","计" "人数",,

,,

"0",,

,"0",,

,"0",,

,"0",,

,"0",,

,"0",,

,"0",,

,"0",,

,"0",,

,"0" "学生自主管理组织干部名单",,

"职务",,

,"团长",,

,"营长",,

,"宣传",,

,"内务管理",,

,"安全",,

,"文艺" ,,

"姓名" ,,

"班级" "学校对素质教育活动和","营地保障管理工作要求" "备注",,

"此表内容重要,请务必填写齐全,于月日前将此表传真至东方绿舟――上海市青少年校外活动" ,,

"营地对外联络部潘民老师收.营地

电话:59233000(总机)传真:59233058手机:13301628485" ,,

"

网址:WWW.orientalland.com.cn(上海学生教学计划课程下载此表)

邮箱:[email protected]" ,,

"根据公安部门的要求,来营地的外籍教师和学生请填写《外籍人员登记表》并附《护照》原件. "学校确认人:(签名) , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

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