このことについて交付してよいでしょうか。伺います。                                              発行年月日                    発行番号
 
 卒            校    長   副校長       教    頭     事務長
                                                                  事 務
                                                                  担当者
                                                                              グループ
                                                                              リーダー
                                                                                               発 行
                                                                                               担当者               年    月    記 入 例
                                                                                                                                日
 
                                                                                                               公         印         第                 号
 
                                                                                                                    年    月    日
 
 
                                             証      明          書        等        交        付       願
                           昭和                                                                                                                  卒    業
  卒業年月日・学科         平成              27     年    3      月   10       日       全日制の課程 普通科                                     修    了
                           令和         西暦（                         年）                                                                      退    学
  卒業時学級及び担任名                                          4      組                                   教諭
         ふりがな           かまくら               たろう                                                    昭和・平成
                                                                                                                                                        男
                                                                                                                           年        月       日生      ・
        卒業時氏名          鎌倉 太郎                                                                        西暦（                  ）年               女
                          （〒 244-0806                   ）
         住    所                  鎌倉市七里ガ浜〇〇〇
                                                                                                         電話番号（ 0467-32-××××                        ）
 証明書を必要とす           □        進学           □        就職           □        資格取得             □     奨学生出願
 る理由                     □        外国留学       □        その他（                                                              ）
                          卒業証明書                                                                    通
                                                                                                 2
                          修了証明書                                                                    通
                          成績証明書                                                                    通
 
                          単位修得証明書                                                                通
                          児童（生徒・学生）健康診断票の写し                                            通           1通につき 400 円
 
   証明書等の種類         推薦¹書                                                                        通
                          発行できない旨の証明書                                               1       通
                          ＊必要な証明書の種類（ 調査書                                                 ）
                          その他                                                                        通
                          （                                                                            ）
                          調査書                                                                        通           1通につき 500 円
 
                          発行できない旨の通知書                      (調査書)                 1       通           無        料
 
    合              計                                                                         4       通                                   1200           円
 
 上記のとおり交付を申請します。
         令和 〇     年    〇    月     〇    日
 
    神奈川県立鎌倉高等学校長                          殿
                                                                                   氏     名          鎌倉 太郎
 注意    証明書を必要とする理由の欄は、該当理由にレ点をつけてください。                                                                   窓口・郵送
         英文での証明書が必要な場合は英文用の証明書等発行願を使用して申請してください。                                                   原符
         発行できない旨の「証明書」が必要な場合はその他証明書の欄より申請してください。                                                     第               号
                          本人確認書類（身分証）：保険証・運転免許証・学生証・マイナンバーカード・その他（                                                   ）