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["出国留学党员保留组织关系申请（审核）表"]
["姓名",null,"性别",null,"民族","免冠照片"]
["出生年月",null,"入党时间"]
["身份证号码"]
["组织关系所在单位\n党组织名称",{"$nulls":3},"正式或预备党员"]
["留学学校",{"$nulls":3},"手机\\Email\\qq\\微信"]
["请假起止时间",{"$nulls":3},"党费交纳截至时间"]
["通讯地址","中文"]
[null,"英文"]
["国内联系人姓名",null,"与本人关系",null,"手机、座机、微信"]
["国内联系人单位及职务",{"$nulls":3},"国内联系人住址"]
["所在党支部审查意见","党支部名称     支部书记签字或盖章"]
[null,"   年   月    日"]
["院系党组织审批意见","盖章     党委书记签字或盖章"]
[null,"年    月   日"]
["备注"]
["注：1、本表由申请人填写、院系党组织审批后，连同本人书面申请一并存入本人档案。2、此表一式三份，院系党组织、本人档案各存一份，高校党委组织部门备案一份。"]

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