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Załącznik nr 1  - Oświadczenie  o zamieszkaniu kandydata na terenie Miasta Kołobrzeg                                                                                                                                              

 

             …………………

data

……………………………………………………..

imię i nazwisko rodziców(opiekunów prawnych) kandydata

 ……………………................................................

 adres zamieszkania

 

 

 

 

OŚWIADCZENIE

 

 

                Na podstawie art. 20 c. ust. 1  ustawy z dnia 7 września 1991 r.  o systemie oświaty (Dz. U. z 2004 r. Nr 256, poz. 2572 z późn. zm.) oświadczam, że  moje dziecko ………………………………………………………………………………………………………

(imię  i nazwisko)

zamieszkuje na terenie Miasta Kołobrzeg.

 

Jednocześnie oświadczam, że jestem świadomy(a) odpowiedzialności karnej za złożenie fałszywego oświadczenia.

 

 

 

 ………………………………………

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