{"id":1373,"date":"2025-08-24T16:19:40","date_gmt":"2025-08-24T14:19:40","guid":{"rendered":"https:\/\/lozoi.szczecin.pl\/autoinstalator\/wordpressplugins\/?page_id=1373"},"modified":"2025-09-18T15:55:28","modified_gmt":"2025-09-18T13:55:28","slug":"wnioski-i-formularze","status":"publish","type":"page","link":"https:\/\/lozoi.szczecin.pl\/autoinstalator\/wordpressplugins\/index.php\/wnioski-i-formularze\/","title":{"rendered":"Wnioski i formularze"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"1373\" class=\"elementor elementor-1373\">\n\t\t\t\t<div class=\"elementor-element elementor-element-a8bfd9c e-flex e-con-boxed e-con e-parent\" data-id=\"a8bfd9c\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-ea91a6b elementor-widget elementor-widget-text-editor\" data-id=\"ea91a6b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<ul><li><a href=\"https:\/\/lozoi.szczecin.pl\/autoinstalator\/wordpressplugins\/wp-content\/uploads\/2025\/09\/wniosek-o-wydanie-m-legitymacji.docx\"><strong>Wniosek o wydanie mLegitymacji &#8211; do pobrania<\/strong> <\/a><\/li><li><strong><a href=\"https:\/\/lozoi.szczecin.pl\/autoinstalator\/wordpressplugins\/wp-content\/uploads\/2025\/09\/Informator-mObywatel-Junior.pdf\">Informator mObywatel Junior<\/a><\/strong><\/li><\/ul><p><strong>Legitymacje szkolne<br \/><\/strong>W przypadku zagubienia lub zniszczenia legitymacji nale\u017cy wp\u0142aci\u0107 na konto szko\u0142y 9 z\u0142.<br \/>Nr konta:\u00a076 10204795 0000 9502 0278 5889<br \/>i zg\u0142osi\u0107 si\u0119 z podaniem, dowodem wp\u0142aty i z 1 zdj\u0119ciem do sekretariatu.<\/p><hr \/><ul><li><strong><a href=\"https:\/\/lozoi.szczecin.pl\/autoinstalator\/wordpressplugins\/wp-content\/uploads\/2025\/08\/Wniosek-o-wydanie-duplikatu-swiadectwa_legitymacji-szkolnej.pdf\">Wniosek o wydanie<\/a> <a href=\"https:\/\/lozoi.szczecin.pl\/autoinstalator\/wordpressplugins\/wp-content\/uploads\/2025\/08\/Wniosek-o-wydanie-duplikatu-swiadectwa_legitymacji-szkolnej.pdf\">duplikatu \u015bwiadectwa \/ legitymacji szkolnej &#8211; do pobrania\u00a0<\/a><\/strong><\/li><\/ul><p><strong>Duplikaty \u015bwiadectw<br \/><\/strong>W przypadku zagubienia lub zniszczenia \u015bwiadectwa nale\u017cy wp\u0142aci\u0107 na konto szko\u0142y 26 z\u0142<br \/>Nr konta:\u00a076 10204795 0000 9502 0278 5889<\/p><hr \/><ul><li><a href=\"https:\/\/lozoi.szczecin.pl\/autoinstalator\/wordpressplugins\/wp-content\/uploads\/2025\/09\/zwolnienie-w-f-druk-1.pdf\"><strong>Wniosek o zwolnienie z wychowania fizycznego &#8211; do pobrania<\/strong><\/a><\/li><\/ul><hr \/><ul><li><strong><a href=\"https:\/\/lozoi.szczecin.pl\/autoinstalator\/wordpressplugins\/wp-content\/uploads\/2025\/09\/WNIOSEK-dofinasowanie-podrecznikow.docx\">Wniosek o dofinansowanie zakupu podr\u0119cznik\u00f3w dla uczni\u00f3w posiadaj\u0105cych orzeczenie o potrzebie kszta\u0142cenia specjalnego- do pobrania<\/a><\/strong><\/li><li><strong><a href=\"https:\/\/lozoi.szczecin.pl\/autoinstalator\/wordpressplugins\/wp-content\/uploads\/2025\/09\/OSWIADCZENIE-O-ZAKUPIE-PODRECZNIKOW-.docx\">O\u015bwiadczenie o zakupie podr\u0119cznik\u00f3w\u00a0dla uczni\u00f3w posiadaj\u0105cych orzeczenie o potrzebie kszta\u0142cenia specjalnego &#8211; do pobrania<\/a><\/strong><\/li><\/ul><hr \/><hr \/><hr \/><p style=\"text-align: center;\"><span style=\"color: #0000ff;\"><strong>Wniosek <\/strong><\/span><span style=\"color: #0000ff;\"><strong>o wydanie mLegitymacji:\u00a0 \u00a0<\/strong><\/span><\/p><p>&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0Szczecin, dn\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026<\/p><p>(Imi\u0119 i nazwisko rodzic\u00f3w\/opiekun\u00f3w prawnych)<\/p><p>\u00a0\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026..\u2026\u2026.<\/p><p>(adres zamieszkania, telefon)<\/p><p>\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026..<\/p><p>\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0Dyrektor<\/p><p>\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 Liceum Og\u00f3lnokszta\u0142c\u0105cego<\/p><p>\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 z Oddzia\u0142ami Integracyjnymi<\/p><p>\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0w Szczecinie<\/p><p>\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0Wniosek o wydanie mLegitymacji<\/p><table><tbody><tr><td width=\"226\"><p><strong>Imi\u0119 i nazwisko ucznia<\/strong><\/p><\/td><td width=\"378\">\u00a0<\/td><\/tr><tr><td width=\"226\"><p><strong>Klasa<\/strong><\/p><\/td><td width=\"378\">\u00a0<\/td><\/tr><tr><td width=\"226\"><p><strong>Data urodzenia<\/strong><\/p><p><strong>Miejsce urodzenia<\/strong><\/p><\/td><td width=\"378\">\u00a0<\/td><\/tr><tr><td width=\"226\"><p><strong>Pesel<\/strong><\/p><\/td><td width=\"378\">\u00a0<\/td><\/tr><tr><td width=\"226\"><p><strong>Adres zamieszkania<\/strong><\/p><\/td><td width=\"378\">\u00a0<\/td><\/tr><\/tbody><\/table><ul><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Zdj\u0119cie do\u0142\u0105czone do wniosku powinno spe\u0142nia\u0107 takie same kryteria jak zdj\u0119cie do dowodu\u00a0 \u00a0 \u00a0 \u00a0 osobistego lub paszportu (https:\/\/obywatel.gov.pl\/wyjazd-za-granice\/zdjecie-do-dowodu-lub-paszportu);<\/span><\/li><li>Zaznajomi\u0142em(am) si\u0119 z informatorem mObywatel Junior;<\/li><li>Zapozna\u0142em(am) si\u0119 z regulaminem us\u0142ugi mLegitymacja w aplikacji mObywatel Junior;<\/li><li>Wyra\u017cam zgod\u0119 na przetwarzanie powy\u017cszych danych osobowych.<\/li><\/ul><p>Potwierdzam odbi\u00f3r loginu i has\u0142a do Zintegrowanej Platformy Edukacyjnej(ZPE : https:\/\/zpe.gov.pl), gdzie po zalogowaniu pobior\u0119 kod QR do aplikacji mObywatel Junior.<\/p><p>\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026..\u2026.<\/p><p>\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 (podpis rodzica lub opiekuna prawnego)<\/p><hr \/><p style=\"text-align: center;\"><strong><span style=\"color: #0000ff;\">Wniosek o wydanie duplikatu \u015bwiadectwa legitymacji szkolnej:<\/span><\/strong><\/p><p><em>\u00a0<\/em><\/p><p style=\"text-align: left;\"><strong>Dane wnioskodawcy<\/strong><\/p><p style=\"text-align: left;\">\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026<\/p><p style=\"text-align: left;\">(imi\u0119 i nazwisko, klasa)<\/p><p style=\"text-align: left;\">\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026<\/p><p style=\"text-align: left;\">(data i miejsce urodzenia)<\/p><p style=\"text-align: left;\">\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026<\/p><p style=\"text-align: left;\">Pesel<\/p><p>\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026<\/p><p style=\"text-align: left;\">Adres do korespondencji i nr telefonu<\/p><p style=\"text-align: left;\">\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026..\u2026<\/p><p style=\"text-align: left;\">(ulica\/ numer domu, mieszkania, kod pocztowy, miejscowo\u015b\u0107, telefon kontaktowy)<\/p><p><strong>Prosz\u0119 o wydanie duplikatu:<\/strong><\/p><p>\u015awiadectwa dojrza\u0142o\u015bci- uczni\u00f3w kt\u00f3rzy uko\u0144czyli szko\u0142\u0119 do 2024 roku*<\/p><p>\u015awiadectwa uko\u0144czenia szko\u0142y*<\/p><p>Legitymacji szkolnej*<\/p><p>wydanego\/nej w \u2026\u2026\u2026\u2026\u2026..roku, kt\u00f3rego orygina\u0142 zosta\u0142 <em>(nale\u017cy poda\u0107 okoliczno\u015bci utraty dokumentu) <\/em>\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026.\u2026\u2026\u2026\u2026..\u2026\u2026\u2026\u2026&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;..\u2026\u2026\u2026&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;..<\/p><p>Op\u0142ata za wydanie duplikatu \u015bwiadectwa w wysoko\u015bci 26 z\u0142, legitymacji w wysoko\u015bci 9 z\u0142, zosta\u0142a wp\u0142acona na rachunek bankowy Liceum Og\u00f3lnokszta\u0142c\u0105cego z Oddzia\u0142ami Integracyjnymi w Szczecinie. Potwierdzenie dowodu wp\u0142aty w za\u0142\u0105czeniu.<\/p><p style=\"text-align: right;\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026<\/p><p style=\"text-align: right;\">\u00a0\u00a0 (data i czytelny podpis wnioskodawcy)<\/p><p><strong>\u00a0<\/strong><\/p><p style=\"text-align: center;\"><strong>O\u015aWIADCZENIE<\/strong><\/p><p><strong>\u00a0<\/strong>Pouczony(a) o odpowiedzialno\u015bci karnej z art.272 kk za sk\u0142adanie fa\u0142szywych o\u015bwiadcze\u0144 (przest\u0119pstwo zagro\u017cone kar\u0105 pozbawienia wolno\u015bci do lat 3).Stwierdzam, \u017ce przedstawione we wniosku okoliczno\u015bci s\u0105 prawdziwe. Jednocze\u015bnie przyjmuj\u0119 do wiadomo\u015bci , \u017ce z chwil\u0105 otrzymania duplikatu traci wa\u017cno\u015b\u0107 orygina\u0142 dokumentu. W przypadku odnalezienia utraconego orygina\u0142u zobowi\u0105zuj\u0119 si\u0119 do zwr\u00f3cenia go do LOzOI w Szczecinie.<\/p><p style=\"text-align: right;\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026<\/p><p style=\"text-align: right;\">\u00a0(data i czytelny podpis)<\/p><p>*) niepotrzebne skre\u015bli\u0107<\/p><hr \/><p style=\"text-align: center;\"><strong><span style=\"color: #0000ff;\">Wniosek o zwolnienie z wychowania fizycznego:<\/span><\/strong><\/p><p><em>\u00a0<\/em><\/p><p style=\"text-align: right;\">\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0Szczecin, dnia\u2026\u2026\u2026\u2026\u2026<\/p><p>\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026..\u2026\u2026\u2026.\u2026\u2026..<\/p><p>(Imi\u0119 i nazwisko rodzica lub opiekuna)<\/p><p>\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026&#8230;\u2026\u2026..\u2026.\u2026.<\/p><p>(Adres)<\/p><p>\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026.<\/p><p style=\"text-align: right;\"><strong>\u00a0<\/strong><strong>Dyrektor <\/strong><\/p><p style=\"text-align: right;\"><strong>Liceum Og\u00f3lnokszta\u0142c\u0105cego <\/strong><\/p><p style=\"text-align: right;\"><strong>Z Oddzia\u0142ami Integracyjnymi<\/strong><\/p><p style=\"text-align: right;\"><strong>w Szczecinie<\/strong><\/p><p style=\"text-align: left;\"><strong>\u00a0<\/strong><\/p><p style=\"text-align: center;\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Uprzejmie prosz\u0119 o zwolnienie mojej c\u00f3rki\/ syna\u2026\u2026&#8230; \u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026 uczennicy\/ ucznia klasy \u2026\u2026\u2026\u2026\u2026\u2026 z zaj\u0119\u0107 wychowania fizycznego od \u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026 do \u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026 roku szkolnego \u2026\u2026\u2026\u2026&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;\u2026\u2026\u2026&#8230;&#8230;&#8230;&#8230;&#8230;\u2026<\/p><p style=\"text-align: center;\">Do podania do\u0142\u0105czam za\u015bwiadczenie lekarza o ograniczonej mo\u017cliwo\u015bci ucznia w zaj\u0119ciach z wychowania fizycznego.<\/p><p style=\"text-align: center;\"><u>Jednocze\u015bnie o\u015bwiadczam, \u017ce bior\u0119 pe\u0142n\u0105 odpowiedzialno\u015b\u0107 za c\u00f3rk\u0119\/ syna w czasie trwania lekcji wychowania fizycznego.<\/u><\/p><p style=\"text-align: right;\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026..<\/p><p style=\"text-align: right;\">\u00a0(podpis opiekuna, rodzica)<\/p><hr \/>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-36c27ec e-flex e-con-boxed e-con e-parent\" data-id=\"36c27ec\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-2b91a27 elementor-widget elementor-widget-text-editor\" data-id=\"2b91a27\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Lorem ipsum dolor sit amet, consectetur adipiscing elit. Ut elit tellus, luctus nec ullamcorper mattis, pulvinar dapibus leo.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-77e39b0 e-flex e-con-boxed e-con e-parent\" data-id=\"77e39b0\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-218d8a5 elementor-widget elementor-widget-text-editor\" data-id=\"218d8a5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Lorem ipsum dolor sit amet, consectetur adipiscing elit. Ut elit tellus, luctus nec ullamcorper mattis, pulvinar dapibus leo.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-191c13f e-flex e-con-boxed e-con e-parent\" data-id=\"191c13f\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-314ce61 elementor-widget elementor-widget-text-editor\" data-id=\"314ce61\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Lorem ipsum dolor sit amet, consectetur adipiscing elit. Ut elit tellus, luctus nec ullamcorper mattis, pulvinar dapibus leo.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Wniosek o wydanie mLegitymacji &#8211; do pobrania Informator mObywatel Junior Legitymacje szkolneW przypadku zagubienia lub zniszczenia legitymacji nale\u017cy wp\u0142aci\u0107 na konto szko\u0142y 9 z\u0142.Nr konta:\u00a076 10204795 0000 9502 0278 5889i zg\u0142osi\u0107 si\u0119 z podaniem, dowodem wp\u0142aty i z 1 zdj\u0119ciem do sekretariatu. Wniosek o wydanie duplikatu \u015bwiadectwa \/ legitymacji szkolnej &#8211; do pobrania\u00a0 Duplikaty \u015bwiadectwW [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[],"tags":[],"class_list":["post-1373","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/lozoi.szczecin.pl\/autoinstalator\/wordpressplugins\/index.php\/wp-json\/wp\/v2\/pages\/1373","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/lozoi.szczecin.pl\/autoinstalator\/wordpressplugins\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/lozoi.szczecin.pl\/autoinstalator\/wordpressplugins\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/lozoi.szczecin.pl\/autoinstalator\/wordpressplugins\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/lozoi.szczecin.pl\/autoinstalator\/wordpressplugins\/index.php\/wp-json\/wp\/v2\/comments?post=1373"}],"version-history":[{"count":42,"href":"https:\/\/lozoi.szczecin.pl\/autoinstalator\/wordpressplugins\/index.php\/wp-json\/wp\/v2\/pages\/1373\/revisions"}],"predecessor-version":[{"id":1565,"href":"https:\/\/lozoi.szczecin.pl\/autoinstalator\/wordpressplugins\/index.php\/wp-json\/wp\/v2\/pages\/1373\/revisions\/1565"}],"wp:attachment":[{"href":"https:\/\/lozoi.szczecin.pl\/autoinstalator\/wordpressplugins\/index.php\/wp-json\/wp\/v2\/media?parent=1373"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/lozoi.szczecin.pl\/autoinstalator\/wordpressplugins\/index.php\/wp-json\/wp\/v2\/categories?post=1373"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/lozoi.szczecin.pl\/autoinstalator\/wordpressplugins\/index.php\/wp-json\/wp\/v2\/tags?post=1373"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}