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["附件"]
["莆田市中小学高层次基础教育人才培育对象申请登记表"]
["学校（单位）名称：                               填报时间：  年  月 日"]
["姓名"," ",null,"性别"," ","出生\n年月"," ",null,null,"参加工作时间 ",null," ",null,"学科",null,null," "]
["现任职务及\n取得资格时间",null," ",null,"聘任时间",null," ",null,"现任行政职务\n及任职时间",null,null," ",null,"取得教师资格类别（学段、学科）",{"$nulls":3}," "]
["所在\n地域","□ 乡村\n\n□ 城镇",null,"人员\n类别",null,"□专任教师        □特殊教育教师\n□中心小学、普通中学校级正职\n□中心小学、普通中学校级副职或完全小学校长\n□中心小学、完全小学、普通中学中层干部\n□进修学校教师、教研、电教人员",{"$nulls":9},"晋升\n形式",null,"□正常晋升  \n\n□转评"]
["任现职以来班主任工作\n起止年限",{"$nulls":5},"视同班主任工作\n或不作要求情况",null,null," ",null,null,"申报一级教师教育教学\n能力水平考试成绩"]
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["何时何校\n进修何课程",null,null," "]
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["送教、送培下乡情况",{"$nulls":4}," "]
["指导培养青年教师情况"]
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["备注","                                                                                             参照                            评选条件标准（评选市级及以上领衔名师、特级教师、省级及以上学科带头人、省级及以上名校长、正高级教师），暂时缺少的条件：1.需明确意向评选职务职称；2.意向参评多项职务的，需分别列出每项职务缺少的条件（2项以内）。"]
["本人承诺所填内容均属实（本人签字）：      "]
["学校（单位）意见：                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               ",{"$nulls":8},"各县区教育局（事务局）意见：                                                                                                                "]