附件4
2015年岳阳市市区初中毕业学业考试体育测试参考报名表
学校(盖章)： 填报人： 联系电话： 填表时间： 第 组
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序号 |
学籍号 |
姓名 |
性别 |
学校测试部分20分 |
统一测试部分80分 |
体育测试总分 |
参考
情况 |
|
体育锻炼考核成绩 |
身体素质测试成绩 |
运动技能测试成绩 |
体质健康测试成绩 |
小计 |
1000/800米
测试成绩 |
得分 |
立定跳远
测试成绩 |
得分 |
跳绳测试成绩 |
得分 |
小计 |
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1 |
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2 |
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3 |
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4 |
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5 |
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6 |
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7 |
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8 |
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9 |
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10 |
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11 |
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12 |
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13 |
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14 |
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15 |
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16 |
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17 |
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18 |
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19 |
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20 |
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21 |
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22 |
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23 |
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24 |
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25 |
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26 |
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27 |
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28 |
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29 |
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30 |
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注、1．按男女编组、分开填报； 2．学籍号以岳阳市基教管理平台学籍号为准，按从小到大顺序排列，报名时须填好学校测试部分成绩； 3．每页填报人数为30人，超过部分另起一页；4．纸质文档和电子文档分别报送7份和1份，并发送邮件至cjk8225236@163.com；5．免考、缓考、缺考情况请在参考情况栏注明，并具体说明某一个项目或全部项目。
