Obrazac 11

REPUBLIKA HRVATSKA

______________________________________________________________ (naziv i sjedište škole)

______________________________________________________________

Klasa: __________________ Urbroj: __________________ Matični broj: __________________

S V J E D O D Ž B A P R E V O D N I C A

______________________________________________________________ (ime i prezime)

OIB

sin/kći ________________________________________________________________ (ime i prezime roditelja)

rođen ______________________________ godine, mjesto rođenja ___________________________________ (datum)

država rođenja _______________________________ državljanstvo ___________________________________

upisan___ u _______________________________________________________ u ________________ razred (vrsta škole - osnovna, gimnazija, strukovna kvalifikacija/zanimanje)

prelazi _______________ u ____________________________________ u ____________________________ (datum) (vrsta škole - osnovna, gimnazija, strukovna kvalifikacija/zanimanje) (naziv i sjedište škole)

Temeljem podataka iz razredne knjige u školskoj godini _____/_____ učeni__ je ili nije ocijenjen ___ iz nastavnih predmeta:

.............................................................. _______________________________ .............................................................. _______________________________

.............................................................. _______________________________ .............................................................. _______________________________

.............................................................. _______________________________ .............................................................. _______________________________

.............................................................. _______________________________ .............................................................. _______________________________

.............................................................. _______________________________ .............................................................. _______________________________

.............................................................. _______________________________ .............................................................. _______________________________

.............................................................. _______________________________ .............................................................. _______________________________

.............................................................. _______________________________ .............................................................. _______________________________

.............................................................. _______________________________ .............................................................. _______________________________

.............................................................. _______________________________ .............................................................. _______________________________

Podaci o vladanju učeni___ do ispisa iz škole: _____________________________________________________

___________________________________________________________________________________________

Učeni___ je do dana prijelaza izosta___ _________ sati (od toga neopravdano _________ ). U _______________________________________, ___________________________ 20_____ .

Razredni___: Ravnatelj___: M.P.

___________________________ ___________________________