{\rtf1\ansi\ansicpg1252\uc1\deff0\stshfdbch0\stshfloch0\stshfhich0\stshfbi0\deflang1040\deflangfe1040{\fonttbl{\f0\froman\fcharset0\fprq2{\*\panose 02020603050405020304}Times New Roman;}{\f1\fswiss\fcharset0\fprq2{\*\panose 020b0604020202020204}Arial;} {\f36\froman\fcharset238\fprq2 Times New Roman CE;}{\f37\froman\fcharset204\fprq2 Times New Roman Cyr;}{\f39\froman\fcharset161\fprq2 Times New Roman Greek;}{\f40\froman\fcharset162\fprq2 Times New Roman Tur;} {\f41\froman\fcharset177\fprq2 Times New Roman (Hebrew);}{\f42\froman\fcharset178\fprq2 Times New Roman (Arabic);}{\f43\froman\fcharset186\fprq2 Times New Roman Baltic;}{\f44\froman\fcharset163\fprq2 Times New Roman (Vietnamese);} {\f46\fswiss\fcharset238\fprq2 Arial CE;}{\f47\fswiss\fcharset204\fprq2 Arial Cyr;}{\f49\fswiss\fcharset161\fprq2 Arial Greek;}{\f50\fswiss\fcharset162\fprq2 Arial Tur;}{\f51\fswiss\fcharset177\fprq2 Arial (Hebrew);} {\f52\fswiss\fcharset178\fprq2 Arial (Arabic);}{\f53\fswiss\fcharset186\fprq2 Arial Baltic;}{\f54\fswiss\fcharset163\fprq2 Arial (Vietnamese);}}{\colortbl;\red0\green0\blue0;\red0\green0\blue255;\red0\green255\blue255;\red0\green255\blue0; \red255\green0\blue255;\red255\green0\blue0;\red255\green255\blue0;\red255\green255\blue255;\red0\green0\blue128;\red0\green128\blue128;\red0\green128\blue0;\red128\green0\blue128;\red128\green0\blue0;\red128\green128\blue0;\red128\green128\blue128; \red192\green192\blue192;}{\stylesheet{\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1040\langfe1040\cgrid\langnp1040\langfenp1040 \snext0 Normal;}{\*\cs10 \additive \ssemihidden Default Paragraph Font;} {\*\ts11\tsrowd\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\trcbpat1\trcfpat1\tblind0\tblindtype3\tscellwidthfts0\tsvertalt\tsbrdrt\tsbrdrl\tsbrdrb\tsbrdrr\tsbrdrdgl\tsbrdrdgr\tsbrdrh\tsbrdrv \ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1024\langfe1024\cgrid\langnp1024\langfenp1024 \snext11 \ssemihidden Normal Table;}{\*\cs15 \additive \ul\cf2 \sbasedon10 Hyperlink;}{ \s16\ql \li4520\ri0\sl95\slmult0\nowidctlpar\pvpg\phpg\posx460\posy3770\absh-1360\absw8600\wrapdefault\faauto\rin0\lin4520\itap0 \f1\fs18\cf1\lang1040\langfe1040\cgrid\langnp1040\langfenp1040 \sbasedon0 \snext16 Body Text 2;}{\s17\ql \li0\ri0\sl85\slmult0 \nowidctlpar\pvpg\phpg\posx3645\posy2765\absh-715\absw5085\wrapdefault\faauto\rin0\lin0\itap0 \b\fs24\cf1\lang1040\langfe1040\cgrid\langnp1040\langfenp1040 \sbasedon0 \snext0 \ssemihidden caption;}{\s18\ql \li0\ri0\sl360\slmult1 \nowidctlpar\wrapdefault\faauto\rin0\lin0\itap0 \f1\fs18\cf1\lang1040\langfe1040\cgrid\langnp1040\langfenp1040 \sbasedon0 \snext18 Body Text;}{\s19\ql \li0\ri0\sl360\slmult1\nowidctlpar\wrapdefault\faauto\rin0\lin0\itap0 \fs20\cf1\lang1040\langfe1040\cgrid\langnp1040\langfenp1040 \sbasedon0 \snext19 Body Text 2;}{\s20\qj \li230\ri0\nowidctlpar\wrapdefault\faauto\rin0\lin230\itap0 \f1\fs18\cf1\lang1040\langfe1040\cgrid\langnp1040\langfenp1040 \sbasedon0 \snext20 Body Text Indent 2;}}{\*\listtable{\list\listtemplateid1807225646\listsimple{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat0\levelspace0\levelindent0{\leveltext\'01-;}{\levelnumbers;}\fbias0\hres0\chhres0 \fi-360\li600 \jclisttab\tx600\lin600 }{\listname ;}\listid72246613}{\list\listtemplateid579252462\listsimple{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat0\levelspace0\levelindent0{\leveltext\'01-;}{\levelnumbers;} \fbias0\hres0\chhres0 \fi-360\li600\jclisttab\tx600\lin600 }{\listname ;}\listid562718837}{\list\listtemplateid1610777590\listsimple{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat0\levelspace0\levelindent0{\leveltext \'01-;}{\levelnumbers;}\fbias0\hres0\chhres0 \fi-360\li645\jclisttab\tx645\lin645 }{\listname ;}\listid603849735}}{\*\listoverridetable{\listoverride\listid72246613\listoverridecount0\ls1}{\listoverride\listid562718837\listoverridecount0\ls2} {\listoverride\listid603849735\listoverridecount0\ls3}}{\*\rsidtbl \rsid1904808\rsid4397760\rsid6380120\rsid10433195\rsid13067978\rsid15950022\rsid16285540}{\*\generator Microsoft Word 10.0.6835;}{\info{\title DOMANDA DI ISCRIZIONE} {\author ipsia}{\operator Pietro Cappai}{\creatim\yr2008\mo1\dy8\hr19\min8}{\revtim\yr2008\mo1\dy8\hr19\min8}{\printim\yr2007\mo1\dy8\hr8\min41}{\version2}{\edmins0}{\nofpages2}{\nofwords688}{\nofchars3924}{\*\company uf.didattica}{\nofcharsws4603} {\vern16393}{\*\password 00000000}}{\*\xmlnstbl }\paperw11906\paperh16838\margl567\margr567\margt567\margb284\gutter0 \deftab708\widowctrl\ftnbj\aenddoc\hyphhotz283\grfdocevents0\noxlattoyen\expshrtn\noultrlspc\dntblnsbdb\nospaceforul\formshade\horzdoc\dghspace180\dgvspace180\dghorigin1701\dgvorigin1984\dghshow0\dgvshow0 \jexpand\viewkind1\viewscale100\pgbrdrhead\pgbrdrfoot\nolnhtadjtbl\rsidroot10433195 \fet0{\*\wgrffmtfilter 013f}\sectd \linex0\endnhere\sectdefaultcl\sftnbj {\*\pnseclvl1\pnucrm\pnstart1\pnindent720\pnhang {\pntxta .}}{\*\pnseclvl2 \pnucltr\pnstart1\pnindent720\pnhang {\pntxta .}}{\*\pnseclvl3\pndec\pnstart1\pnindent720\pnhang {\pntxta .}}{\*\pnseclvl4\pnlcltr\pnstart1\pnindent720\pnhang {\pntxta )}}{\*\pnseclvl5\pndec\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}{\*\pnseclvl6 \pnlcltr\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}{\*\pnseclvl7\pnlcrm\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}{\*\pnseclvl8\pnlcltr\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}{\*\pnseclvl9\pnlcrm\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}\pard\plain \ql \li2180\ri0\nowidctlpar\wrapdefault\faauto\rin0\lin2180\itap0 \fs20\lang1040\langfe1040\cgrid\langnp1040\langfenp1040 {\b\f1\fs32\cf1\insrsid1904808 DOMANDA DI ISCRIZIONE}{\f1\fs32\cf1\insrsid1904808 \par }\pard \ql \li0\ri0\sl300\slmult0\nowidctlpar\wrapdefault\faauto\rin0\lin0\itap0 {\fs28\cf1\insrsid1904808 Al Dirigente Scolastico dell'Istituto Professionale. "G. FERRARIS" IGLESIAS \par }\pard \ql \li2155\ri0\sl10\slmult0\nowidctlpar\wrapdefault\faauto\rin0\lin2155\itap0 {\f1\fs16\cf1\insrsid1904808 Via Canepa - TeL 0781/26131 - Fax 0781/2613320 - e-mail }{\field\flddirty{\*\fldinst {\f1\fs16\cf1\insrsid1904808 HYPERLINK mailto:ipsiaigl@tin.it }{\f1\fs16\cf1\insrsid1904808 {\*\datafield 00d0c9ea79f9bace118c8200aa004ba90b02000000170000001000000069007000730069006100690067006c004000740069006e002e00690074000000e0c9ea79f9bace118c8200aa004ba90b2e0000006d00610069006c0074006f003a0069007000730069006100690067006c004000740069006e002e00690074000000} }}{\fldrslt {\cs15\ul\cf1\insrsid1904808 ipsiaigl@tin.it}}}\sectd \linex0\endnhere\sectdefaultcl\sftnbj {\f1\fs16\cf1\insrsid1904808 \par }{\f1\fs16\cf1\lang1024\langfe1024\noproof\insrsid1904808 {\shp{\*\shpinst\shpleft-141\shptop137\shpright10793\shpbottom4051\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz10\shplid1074 {\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn fFilled}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8202\dprect \dpx-141\dpy137\dpxsize10934\dpysize3914\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat0\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\f1\fs16\cf1\insrsid1904808 \par \par }\pard \ql \li0\ri0\nowidctlpar\wrapdefault\faauto\rin0\lin0\itap0 {\f1\fs18\cf1\lang1024\langfe1024\noproof\insrsid1904808 {\shp{\*\shpinst\shpleft9725\shptop33\shpright9867\shpbottom175\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz1\shplid1065{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}} {\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8193\dprect\dpx9725\dpy33\dpxsize142\dpysize142 \dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}} {\shp{\*\shpinst\shpleft8727\shptop33\shpright8869\shpbottom175\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz2\shplid1066{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}} {\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8194\dprect\dpx8727\dpy33\dpxsize142\dpysize142 \dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}} {\shp{\*\shpinst\shpleft7529\shptop33\shpright7671\shpbottom175\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz0\shplid1064{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}} {\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8192\dprect\dpx7529\dpy33\dpxsize142\dpysize142 \dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\f1\fs18\cf1\insrsid1904808 _l_ sottoscritt_ __________________________________________________ padre madre tutore \par }{\f1\fs16\cf1\insrsid1904808 Cognome e nome \par \par }\pard\plain \s19\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \fs20\cf1\lang1040\langfe1040\cgrid\langnp1040\langfenp1040 {\f1\insrsid1904808 dell'alunn_ _____ ___________________________________________________________________________ \par }\pard\plain \ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1040\langfe1040\cgrid\langnp1040\langfenp1040 {\f1\fs16\cf1\insrsid1904808 Cognome e nome \par \par }\pard \qc \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\f1\fs24\insrsid1904808 chiede per l'anno scolastico}{\f1\fs28\insrsid1904808 }{\b\f1\fs40\insrsid1904808 200}{\b\f1\fs40\insrsid15950022 8}{ \b\f1\fs40\insrsid1904808 /200}{\b\f1\fs40\insrsid15950022 9}{\f1\fs28\cf1\insrsid1904808 }{\f1\fs24\cf1\insrsid1904808 l'iscrizione dell_ stess_ alla classe}{\f1\fs28\cf1\insrsid1904808 }{\b\f1\fs40\cf1\insrsid1904808 1^}{ \f1\fs40\cf1\insrsid1904808 : \par }\pard\plain \s18\ql \li0\ri0\sl360\slmult1\nowidctlpar\wrapdefault\faauto\rin0\lin0\itap0 \f1\fs18\cf1\lang1040\langfe1040\cgrid\langnp1040\langfenp1040 {\insrsid1904808 \par }{\lang1024\langfe1024\noproof\insrsid1904808 {\shp{\*\shpinst\shpleft5647\shptop48\shpright5789\shpbottom190\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz3\shplid1067 {\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8195\dprect\dpx5647\dpy48\dpxsize142\dpysize142 \dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}} {\shp{\*\shpinst\shpleft1719\shptop8\shpright1861\shpbottom150\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz4\shplid1068{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}} {\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8196\dprect\dpx1719\dpy8\dpxsize142\dpysize142 \dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\insrsid1904808 ELETTRICO ELETTRONICO TURISTICO }{\fs16\insrsid1904808 \par }\pard\plain \ql \li0\ri0\sl360\slmult1\nowidctlpar\wrapdefault\faauto\rin0\lin0\itap0 \fs20\lang1040\langfe1040\cgrid\langnp1040\langfenp1040 {\lang1024\langfe1024\noproof\insrsid1904808 {\shp{\*\shpinst\shpleft5644\shptop24\shpright5786\shpbottom166\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz13\shplid1077{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}} {\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8205\dprect\dpx5644\dpy24\dpxsize142\dpysize142 \dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}} {\shp{\*\shpinst\shpleft1724\shptop38\shpright1866\shpbottom180\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz5\shplid1069{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}} {\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8197\dprect\dpx1724\dpy38\dpxsize142\dpysize142 \dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\f1\fs18\insrsid1904808 MECCANICO }{\fs18\cf1\insrsid1904808 }{\f1\fs18\insrsid1904808 ALBERGHIERO E RISTORAZIONE \par }\pard \ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\fs16\insrsid1904808 }{\insrsid1904808 \par }\pard\plain \s18\ql \li0\ri0\sl360\slmult1\nowidctlpar\wrapdefault\faauto\rin0\lin0\itap0 \f1\fs18\cf1\lang1040\langfe1040\cgrid\langnp1040\langfenp1040 {\lang1024\langfe1024\noproof\insrsid1904808 {\shp{\*\shpinst\shpleft5882\shptop276\shpright6166\shpbottom560\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz14\shplid1079{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}} {\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8206\dprect\dpx5882\dpy276\dpxsize284\dpysize284 \dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\fs16\insrsid1904808 }{\insrsid1904808 Indicare l\rquote eventuale preferenza}{\fs16\insrsid1904808 }{ \insrsid1904808 per i}{\fs16\insrsid1904808 }{\insrsid1904808 percorsi sperimentali}{\b\insrsid1904808 }{\insrsid1904808 di istruzione e formazione professionale (art.28 D.Leg.vo. n.226/2005), \par relativamente all\rquote indirizzo di studi prescelto, apponendo una crocetta \par \par }\pard\plain \ql \li3540\ri0\sl150\slmult0\nowidctlpar\wrapdefault\faauto\rin0\lin3540\itap0 \fs20\lang1040\langfe1040\cgrid\langnp1040\langfenp1040 {\f1\fs18\cf1\lang1024\langfe1024\noproof\insrsid1904808 {\shp{\*\shpinst\shpleft-141\shptop99\shpright10808\shpbottom8624\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz11\shplid1075{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}} {\sp{\sn fFilled}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8203\dprect\dpx-141\dpy99\dpxsize10949\dpysize8525 \dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat0\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\f1\fs18\cf1\insrsid1904808 \par }\pard \ql \li0\ri0\sl150\slmult0\nowidctlpar\wrapdefault\faauto\rin0\lin0\itap0 {\f1\insrsid1904808 \par A tal fine dichiara, in base alle norme sullo snellimento dell'attivit\'e0 amministrativa e consapevole delle responsabilit\'e0 cui va incontro in caso di dichiarazione non corrispondente al vero}{\f1\cf1\insrsid1904808 , che \par }{\cf1\insrsid1904808 \par }\pard \ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\insrsid1904808 - }{\f1\insrsid1904808 l'alunn_}{\insrsid1904808 }{\f1\insrsid1904808 ____________________________ _________________________________________________________}{\insrsid1904808 \par }\pard \ql \li2430\ri0\nowidctlpar\wrapdefault\faauto\rin0\lin2430\itap0 {\fs16\cf1\insrsid1904808 Cognome e nome Codice fiscale \par }\pard \ql \li0\ri0\sl360\slmult1\nowidctlpar\wrapdefault\faauto\rin0\lin0\itap0 {\f1\lang1024\langfe1024\noproof\insrsid1904808 {\shp{\*\shpinst\shpleft3267\shptop286\shpright3551\shpbottom570\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz7\shplid1071{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}} {\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8199\dprect\dpx3267\dpy286\dpxsize284\dpysize284 \dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}} {\shp{\*\shpinst\shpleft2273\shptop286\shpright2557\shpbottom570\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz6\shplid1070{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}} {\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8198\dprect\dpx2273\dpy286\dpxsize284\dpysize284 \dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\f1\insrsid1904808 - \'e8 nat_ a _______________________________________________ Prov. ( _______ ) il ___________________ \par - \'e8 cittadino italiano altro (indicare quale) _________________________________________________ \par - \'e8 residente a _____________________________}{\f1\insrsid16285540 _________________________________________}{\f1\insrsid1904808 (Prov._____) }{\f1\insrsid16285540 \par }{\f1\insrsid1904808 in Via/Piazza }{\f1\insrsid16285540 ____________________________________________________________________}{\f1\insrsid1904808 }{\f1\insrsid16285540 N\'b0 _________}{\f1\insrsid1904808 \par telefono __________}{\f1\insrsid13067978 ______}{\f1\insrsid1904808 ______cellulare______________________}{\f1\insrsid13067978 _________}{\f1\insrsid1904808 __}{\f1\insrsid13067978 ;}{\f1\insrsid1904808 \par }{\f1\cf1\insrsid1904808 - proviene dalla scuola __________________________________________ ove nell'a.s. ______________________ \par }\pard \ql \li0\ri0\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\f1\insrsid1904808 frequenta /o ha frequentato/ la classe _______ /o ha conseguito il diploma di ______________________________ \par }{\f1\insrsid13067978 }{\f1\insrsid1904808 con il seguente giudizio: _____________________}{\f1\insrsid10433195 _____}{\f1\insrsid1904808 _______ ; \par - lingua/e straniera/e studiata/e: _______________________________}{\f1\insrsid10433195 ____________}{\f1\insrsid1904808 ___; \par - che la propria famiglia convivente \'e8 composta da: \par }\pard\plain \s19\ql \li0\ri0\nowidctlpar\wrapdefault\faauto\rin0\lin0\itap0 \fs20\cf1\lang1040\langfe1040\cgrid\langnp1040\langfenp1040 {\f1\insrsid1904808 ______________________________ ______________________________ ____________________________ \par ______________________________ ______________________________ ____________________________ \par ______________________________ ______________________________ ____________________________ \par ______________________________ ______________________________ ____________________________ \par ______________________________ ______________________________ ____________________________ \par ______________________________ ______________________________ ____________________________ \par }\pard\plain \ql \li875\ri0\nowidctlpar\wrapdefault\faauto\rin0\lin875\itap0 \fs20\lang1040\langfe1040\cgrid\langnp1040\langfenp1040 {\f1\fs16\cf1\insrsid1904808 Cognome e nome luogo e data di nascita parentela \par \par }\pard \ql \li5\ri0\sl315\slmult0\nowidctlpar\wrapdefault\faauto\rin0\lin5\itap0 {\f1\cf1\lang1024\langfe1024\noproof\insrsid1904808 {\shp{\*\shpinst\shpleft5437\shptop4\shpright5721\shpbottom288\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz9\shplid1073{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}} {\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8201\dprect\dpx5437\dpy4\dpxsize284\dpysize284 \dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}} {\shp{\*\shpinst\shpleft4747\shptop4\shpright5031\shpbottom288\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz8\shplid1072{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}} {\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8200\dprect\dpx4747\dpy4\dpxsize284\dpysize284 \dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\f1\cf1\insrsid1904808 - \'e8 stato sottoposto alle vaccinazioni obbligatorie si no \par }\pard \ql \li875\ri0\nowidctlpar\wrapdefault\faauto\rin0\lin875\itap0 {\f1\cf1\insrsid1904808 \par }\pard\plain \s19\ql \li0\ri0\nowidctlpar\wrapdefault\faauto\rin0\lin0\itap0 \fs20\cf1\lang1040\langfe1040\cgrid\langnp1040\langfenp1040 {\f1\insrsid1904808 \par }{\b\f1\insrsid1904808 FIRMA _______________________________________ \par }\pard\plain \ql \li0\ri0\nowidctlpar\wrapdefault\faauto\rin0\lin0\itap0 \fs20\lang1040\langfe1040\cgrid\langnp1040\langfenp1040 {\b\f1\insrsid1904808 }{\f1\cf1\insrsid1904808 Data________________________}{\b\f1\insrsid1904808 }{\fs16\cf1\insrsid1904808 Firma di autocertificazione (Leggi 15/98 127/97 131/98) da \par }\pard\plain \s19\ql \li0\ri0\nowidctlpar\wrapdefault\faauto\rin0\lin0\itap0 \fs20\cf1\lang1040\langfe1040\cgrid\langnp1040\langfenp1040 {\fs16\insrsid1904808 sottoscrivere al momento della presentazione della domanda \par }\pard\plain \ql \li10\ri0\nowidctlpar\wrapdefault\faauto\rin0\lin10\itap0 \fs20\lang1040\langfe1040\cgrid\langnp1040\langfenp1040 {\fs16\cf1\insrsid1904808 all'impiegato della scuola \par \par \par \par \par }{\fs16\cf1\lang1024\langfe1024\noproof\insrsid1904808 {\shp{\*\shpinst\shpleft-126\shptop71\shpright10793\shpbottom1732\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz12\shplid1076 {\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn fFilled}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8204\dprect\dpx-126\dpy71\dpxsize10919\dpysize1661 \dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat0\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\cf1\insrsid1904808 \par }\pard\plain \s20\qj \li0\ri0\nowidctlpar\wrapdefault\faauto\rin0\lin0\itap0 \f1\fs18\cf1\lang1040\langfe1040\cgrid\langnp1040\langfenp1040 {\fs20\insrsid1904808 Il sottoscritto dichiara di essere consapevole che la scuola pu\'f2 utilizzare i dati contenuti nella presente \par autocertificazione esclusivamente nell'ambito e per i fini istituzionali propri della P. A.(D.Leg.vo 30 giugno 2003, n.196). \par }\pard\plain \qj \li10\ri0\nowidctlpar\wrapdefault\faauto\rin0\lin10\itap0 \fs20\lang1040\langfe1040\cgrid\langnp1040\langfenp1040 {\f1\insrsid1904808 \par \par }{\f1\cf1\insrsid1904808 Data________________________ Firma}{\b\f1\cf1\insrsid1904808 ______________________________________}{\f1\insrsid1904808 \par }\pard\plain \s19\ql \li0\ri0\sl480\slmult1\nowidctlpar\wrapdefault\faauto\rin0\lin0\itap0 \fs20\cf1\lang1040\langfe1040\cgrid\langnp1040\langfenp1040 {\f1\insrsid1904808 \par \par }}