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["辽宁理工学院辅修专业申请表"]
["学 院",null,"姓 名",null,"学 号"]
["班 级",null,"主修专业",null,"专业大类名称"]
["学 期",null,"辅修专业",null,"专业大类名称"]
["学生本人签字",null,"                            年    月     日  "]
["学生所在单位意见","               负责人签字 :                   公章：                    "]
[null," 年       月       日"]
["辅修专业主办单位意见","               负责人签字:                    公章：                    "]
[null," 年       月       日"]
["教务处  意见","               处长签字:                    公章：                    "]
[null," 年       月       日"]
["备注"]
["注：本表一式四份，教务处、学生所在单位、辅修专业主办单位、学生各一份。"]

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