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["惠州市“惠民速办”民生诉求评议专家库人选推荐（自荐）表"]
["一、基本信息"]
["姓 名",null,"性 别"]
["政治面貌",null,"出生年月"]
["工作单位",null,"所在部门"]
["职 务",null,"职 称"]
["最高学历",null,"专业领域","（如：法律法规、公共管理、教育医疗、建筑工程、心理学等）"]
["通讯地址",null,"工作性质","（如：专职律师、院校教师、专科医生、社区工作者等）"]
["手 机",null,"电子邮箱"]
["二、专业资质与学术背景"]
["1. 教育经历（从最高学历开始填写至高中或同等学历）"]
["起止时间","毕业院校","专业","学历/学位"]
[]
[]
[]
[]
["2. 专业资格/资质证书"]
["证书名称","颁发机构",null,"取得年份"]
[]
[]
[]
["三、工作经历经验"]
["1. 主要工作经历（请按时间倒序填写）"]
["起止时间","工作单位","部门及职务","主要工作内容"]
[]
[]
[]
[]
[]
["2. 与民生诉求领域相关的实务经验"]
["（请重点简要阐述处理群众诉求、政策制定、法律实务及参与社会管理服务等方面的具体经验）"]
["四、评议工作承诺"]
["承诺事项：本人郑重承诺：所填信息真实准确；遵守评议规则与纪律；秉持客观、公正、中立原则；严格遵守回避制度；履行保密义务。"]
["注：入选专家库另行签订纸质版保密承诺书。"]
["承诺人签名：________________"]
["日期：______年______月______日"]
["五、推荐单位意见"]
["推荐意见："]
["六、审核部门意见"]
["评审意见："]
["□ 同意纳入专家库 □ 不予纳入"]
["备注"]