教 頭                  事務長         進路指導部長     教務部長       作成者       事務担当
 
 
 
 
 卒業生等用
 ※太枠内を記入してください
      交付願提出月日         令和            年        月     日        電話受理         記入者（                      ）
 
      交付願受理月日         令和            年        月     日
      交付予定年月日         令和            年        月     日
 
 
 
                  札幌手稲高等学校証明書交付願
 
 
                                                  氏          名
 
                                                  生 年 月 日                 S・H          年        月         日生
 
                                                  現    住    所
 
                                                  電 話 番 号
 
                                                  卒業年月日                S・H・R          年         月          日卒
 
                                             卒業クラス・担任                                 組                   先生
 
 
             証        明        書               交付部数           単価                金額                   備考
 
 1     卒 業 証 明 書           ※
                                                             通     400 円                         円
 
 2     修 了 証 明 書           ※
                                                             通     400 円                         円
 
 3     成 績 証 明 書           ※
                                                             通     400 円                         円
 
 4     単位 修得証明 書         ※
                                                             通     400 円                         円
 
 5     調        査        書    ※                         通     400 円                         円
 
 6     そ        の        他   ※
                                                             通     400 円                         円
 
             北海道収入証紙合計額                                                                  円
 ※英文の各証明書は備考欄に           英文   と記入してください。
 
                                                        申 請      理   由
 
 
 
 
                                       ※調査書を申請する方は、『出願先一覧』の記入も願います。
                                      交付まで校内の流れ                              （調査書：作成者進路¹指導部長教頭事務）
                                                                            （成績・単位修得証明書：作成者教務部長教頭事務）
                                                                                （英文による各証明書：国際交流委員会教頭事務）
 出願先一覧表
                       年度卒（担任：        ） 氏名
 
 
 
 整理                                                                    出 願
        出願先学校名             学     部      学科・専攻・日程・方式
 番号                                                                    締切日
 
 
  1                                                                        ／
 
 
 
 
  2                                                                        ／
 
 
 
 
  3                                                                        ／
 
 
 
 
  4                                                                        ／
 
 
 
 
  5                                                                        ／
 
 
 
 
  6                                                                        ／
 
 
 
 
  7                                                                        ／
 
 
 
 
  8                                                                        ／
 
 
 
 
  9                                                                        ／
 
 
 
 
  10                                                                       ／