特別活動の記録・指導上参考となる諸事項
 長野県長野商業高等学校長 様
                                                                                                                                                       平成
                                                                                                                                         第     学年   令和      年度
                                                    人物に関する証明書                                                                   第     学年
                                                                                                                                                       平成
                                                                                                                                                       令和      年度
                                                                                                                                                       平成
                                                                                                                                         第     学年   令和      年度
                                                                                                                                                       平成
                                                                                                                                         第     学年   令和      年度
 貴校への（ 転入学 ・ 編入学 ）を希望している下記の人物について、以下のように証明します。※転入学・編入学のどれかに○                                  平成
                                                                                                                                         第     学年   令和      年度
    ふりがな                                                                        男     ( 昭和 ・ 平成 )    年   月       日生          教科に対する取り組み・行動傾向・交友関係・家庭環境・所見・転入学・編入学するに至った経緯等について、生徒の
                                                                                                                                         人となりがよく伝わるように記入して下さい。
    氏     名                                                                       女                                  満      歳
 
                     (〒                            )
    住     所
 
 入学前の
                     (平成 ・令和 ）      年            月                                                 中学校卒業
 経歴
                                                                                           課程名・
 高校名
                                                                                           学科名
 
                     (〒                            )
 学校所在地
 
 
 入 学               （ 平成 ・令和 ）         年            月       日 入学
 
   在（退）学        第     学年在学中。 令和                       年  月  日より ( 休学 ・長期欠席 )中
     状況            （ 平成 ・令和 ）  年 月                     日 第 学年退学。 退学後の進路¹（                                   ）
                             履修科目                        単位数         履修科目        単位数             学習状況
 
 
 
   履修科目
     及び
   単位数
 （総合的な学習(探
 究)の時間を含む）
 
 
 
 
 修得単位数の合計            (ホームルームを除く)                                                                            単位
 
 
                                                                       出欠の記録
 
                                                        出席停止・          出席しなけ
                                                                   留学中の
                                       授業日数         忌引等の            ればならな 欠席日数 出席日数                備 考
                                                                   授業日数
                                                        日数                い日数
                                                                                                                                              記入責任者氏名         (生徒との関係           )                                            印
                     平成
   第     学年 令和           年度
                     平成
                                                                                                                                                以上の記載事項には誤りのないことを証明します。
   第     学年       令和     年度
                                                                                                                                                              令和      年    月     日
                     平成
   第     学年       令和     年度
                     平成
   第     学年       令和     年度                                                                                                                                                                        学校長                                 印
                     平成
   第     学年       令和     年度