卒
        このことについて交付してよいでしょうか。                             発行年月日      発 行 番 号                   公            印
                                                    事    務
 校     長    副 校 長    教   頭   事 務 長                     担当教諭
                                                    担 当 者                 令和     年                                  令和           年
                                                                                             第                     号
                                                                                 月   日                                    月           日
 
 
                                      証 明 書 等 交 付 願
                           昭和                                                                                                     卒   業
 卒業年月日・学科          平成                年           月              日        全日制             普通科                     修   了
                                                                                                                                    退   学
                           令和
 卒 業 時 学 級
                                                                            組                                      教     諭
 及 び 担 任 名
  ふ    り    が    な
                                                                                      昭和                                               男
                                                                                                    年         月        日生            ・
 卒 業 時 氏 名                                                                       平成                                               女
                          （〒                            ） （TEL                                                             ）
 住                 所
 
 
 証明書を必要 と □進               学                   □就       職           □資格取得              □奨学生出願
 す     る    理     由   □外国留学¹                     □その他（                                                       ）
 
                          卒 業 証 明 書                                               通
                          修 了 証 明 書                                               通
                          成 績 証 明 書                                               通         手数料
                          単位修得証明書                                               通                1 通につき             400 円
                          児童（生徒・学生）
                          健康診断の写し                                               通
 証明書等の種 類 推                 薦              書                                 通
                 そ                 の              他                                 通
 
                          調        査              書                                 通                1 通につき             500 円
 
 
                                    計                                                 通                                                円
 
  上記のとおり交付を申請します。
             令和         年        月              日
 
  神奈川県立 寒 川 高等学校長 殿
                                                                     氏          名
 
 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。
                                                                                                          月    日       本人・代理人 確認
         ・推薦書については、担当教諭に御相談ください。
                                                                                                    運転免許証・保険証・学生証
                                                                                                    マイナンバーカード
                                                                                                    卒業時から住所の変更                  有・無