Avizat

Director Departament
De acord,
Prof. coordonator

Domnule Director,

Subsemnatul (a) ___________________________________________ student n anul II

de studiu, anul universitar 2012-2013, domeniul PSIHOLOGIE, programul de studiu Psihologie
clinic evaluare i intervenie terapeutic, forma de nvmnt cu frecven, v rog s
aprobai

ntocmirea

lucrrii

de

disertaie

cu

tema:

____________________________________________________________________________
________________________________________________________________________
_____________________________________________________________________________
sub

coordonarea

tiinific

_____________________________________________________.

Data,

Semntura student,

Domnului Director al Departamentului de Psihologie