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["雅安市人民医院优秀研究生暑期夏令营活动申请表"]
["基本情况","姓    名",null,"性别",null,"申请人\n免冠近照"]
[null,"身份证号"]
[null,"所在学校"]
[null,"所在院系"]
[null,"所在专业"]
[null,"外语水平"]
[null,"通讯地址",null,null,"邮    编"]
[null,"电子邮箱",null,null,"联系电话"]
["兴趣学科"]
["主要学习和工作经历","（自高中起）"]
["何时何地获得何种奖励或荣誉","（本科至今）"]
["何时参加过哪些科研工作，有何学术成果","（发表的论文、出版物或其他能体现自身学术水平的工作成果）"]
["其他对申请具有参考价值的情况"]
["个人陈述","（请介绍个人的学术背景，以及攻读研究生阶段的研究方向、学习计划、就业目标等）"]
["是否有在雅安市人民医院就职的意愿"]
["申请人所在院校\n推荐意见：",null,"\n院系负责人（或导师）：\n            院系盖章：\n                                   年     月     日"]
["申请人声明",null,"   我保证提交的申请表及全部申请材料真实、准确，若有任何弄虚作假行为，我愿意被取消入营资格并承担相应法律及道德责任。\n   特此声明。\n\n                 \n申请人签字：                                    年     月     日"]

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