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["附件一："]
["2021年度平凉陇山工贸有限责任公司高考奋志奖学金申请表"]
["                                                                                               申请条件：1.平凉市崆峒区原建档立卡脱贫户、城市低保家庭子女户\n          2.当年考入“985”“211”双一流大学\n          "]
["申请人姓名",null,"性别",null,"出生日期",null,"照片"]
["是否为原建档立卡脱贫户或城市低保家庭子女户"," □是 □否","建档立卡纳 入系统时间",null,"建档立卡   户编号"]
["录取院校",null,null,"身份证号"]
["现住家庭      详细地址",null,null,"联系电话"]
["自述家庭      贫困情况\n"]
["审\n核                意                  见","高考就读学校（盖章）                                                                      年  月   日",null,null,"平凉陇山工贸有限责任公司                     （盖章）                                     年    月   日"]