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["启东市学前教育政府资助经费申请表"]
["附表一"]
["儿童情况","姓     名",null,"性    别",null,"出生年月"]
[null,"民     族",null,"入园时间",null,"联系电话"]
["家庭经济情况","家庭月总收入",null,"人均月收入",null,"收入来源"]
[null,"家庭住址",null,"邮政编码",null,"家庭人口"]
["家庭成员情况","姓    名","年  龄","与本人关系","工作或学习单位"]
[]
[]
[]
[]
[]
["申请资助理由"]
[]
[]
[]
[null," 申请人：            法定监护人：           申请时间："]
["幼儿园审核意见"]
[]
[]
[null," 幼儿园负责人：　　　　　　　　　　　　幼儿园公章："]
[]
["县级学生资助管理中心意见"]
[]
[]
[null,"　　　　　　　　　　　　　　　　　　　　　公章："]

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