Mu t trnh v vic ngh b nhim Mu s 1: Ban hnh km theo Thng t s

42/2010/TT-BLTBXH ngy 31 thng 12 nm 2010 ca B trng B Lao ng Thng binh v X hi Quy nh v b nhim, cng nhn, b nhim li, cng nhn li
hiu trng trng cao ng ngh, trng trung cp ngh v gim c trung tm dy
ngh.
(1)

CNG HA X HI CH NGHA VIT NAM

(2)

c lp - T do - Hnh phc

.., ngy .. thng .. nm 20..

S: ./

T TRNH
V/v ngh b nhim /c gi chc hiu trng/gim c
Knh gi: [tn ngi c thm quyn b nhim hiu trng/gim c]

I. Nu nhu cu b nhim hiu trng/gim c; tm tt v vic thc hin quy trnh nhn
s v cn c vo quy hoch cn b, tiu chun, iu kin b nhim hiu trng/gim c
xut gii thiu nhn s c th.
-

- Chc nng, nhim v, khi lng cng vic c giao, nh hng pht trin ca

trng/trung tm:
-

Nhu cu cn b p ng yu cu ca trng/trung tm (nu r l do cn thit phi

b nhim hiu trng/gim c).

-

kin ca c quan c thm quyn v vic ph duyt ch trng b nhim.

II. Cn c vo tiu chun, iu kin b nhim hiu trng/gim c v kt qu thc hin

quy trnh b nhim hiu trng trng/gim c trung tm................................... ngh
[ngi c thm quyn b nhim hiu trng/gim c]... xem xt, b
nhim ng/b gi chc v hiu trng trng/gim c trung tm
..............................................................
Tm tt v nhn s ngh b nhim:
-

H v tn:..................................................................................................................

Ngy, thng, nm sinh:............................................................................................

Qu qun:....................................., Dn tc:............................................................

Chc v ng, chnh quyn, on th:....................................................................

n v hin ang cng tc:......................................................................................

- Trnh vn ho, trnh hc vn, hc hm, hc v, trnh l lun chnh tr, ngoi
ng, tin hc.......):......................................................................................................
-

Tm tt qu trnh cng tc:

Chc danh, chc v, n v cng tc (ng, chnh quyn, on

thng

thng

th, t chc x hi), k c thi gian c o to, bi dng v

nm

nm

chuyn mn, nghip v, ...

..

Tm tt nhn xt, nh gi u, khuyt im, mt mnh, mt yu ca hiu

trng/gim c ngh b nhim:

+ Phm cht chnh tr, o c, tc phong, li sng:
+ Nng lc cng tc:
+ Tm tt u im, khuyt im, mt mnh, mt yu:
-

Kt qu ly phiu tn nhim:

+ Hi ngh cn b ch cht ca trng/trung tm: S phiu ng ........phiu/.......phiu

(.......%). S phiu khng ng : ......phiu/......phiu (...%).
+ Hi ngh lin tch ca trng, trung tm: S phiu ng ........phiu/.......phiu (.......%).
S phiu khng ng : ......phiu/......phiu (...%).
(H s h s ngh b nhim km theo)
Trng, trung tm..... ngh [tn c quan c thm quyn b nhim hiu trng/gim
c].. xem xt, quyt nh b nhim ng/b gi chc hiu
trng/gim c ./.

(3)
Ni nhn:
-

Nh trn;

Lu VT, .

(k tn, ng du, ghi r h tn)

(1) Tn c quan qun l trc tip trng/trung tm.

(2) Tn trng/trung tm ngh b nhim hiu trng/gim c.
(3) Chc danh ngi i din lnh o trng/trung tm ngh b nhim hiu
trng/gim c.