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["南方科技大学2019年寒假奥赛集训营报名表"]
[]
["姓 名",{"$nulls":3},"性 别",{"$nulls":3},"年龄",null,"(   岁)",null,"（电子版相片）"]
[]
["电话",{"$nulls":3},"邮箱",{"$nulls":3},"所在高中"]
["紧急联系人",{"$nulls":3},"关系",{"$nulls":3},"电话"]
["家庭住址"]
["个人自述"]
[null,null,"（主要高中学习及数学的学习）\n"]
["活动预期打算","（不超过300字）"]
[]
["主要获奖经历","序号",null,"竞赛名称",null,"比赛名次或荣誉",null,"证明人","竞赛概况"]
[]
[{"$nulls":5},"\n"]
[]
[]
[]
["本\n人\n承\n诺","   所填信息全部属实，如有虚假，本人愿意承担由此造成的一切后果。"]
[null,"                                     签名：               年    月     日"]
["备注：本表请用A4纸正反面打印后签字，获奖证书扫描或拍张与报名表在1月8日前发送至邮箱：wangjq3@sustc.edu.cn。"]

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[16]