Cerere formular de nscriere la Componenta I Instruire i consultan antreprenorial al

Programului Naional de Abilitare Economic a Tinerilor.

I. DATE PERSONALE
Nume, Prenume: _______________________________________________________________________
Sex:
Masculin
Feminin
Adres domiciliu: _____________________________________________________________________
Telefon: ______________________
E-mail: _____________________ Vrsta: ____________
Stare civil:
Necstorit/
Cstorit/
II. NIVELUL EDUCAIEI
Studii medii absolvite (perioada, unitate de nvmnt, specializare):
__________________________________________________________________________________
Studii universitare absolvite (perioada, unitate de nvmnt, specializare):
___________________________________________________________________________________
Studii postuniversitare (perioada, unitate de nvmnt, specializare)
____________________________________________________________________________________
III.

ACTIVITATEA PROFESIONAL

1. V rugm s completai n tabelul urmtor datele referitoare la experiena dvs. profesional:

Instituia/organizaia/firma n care ai
Funcia
Perioada
activat?

2. Ai fost la munc peste hotarele rii?

Da Nu
Dac da, indicai n ce ar? ---------------------------------------------------------IV.
ACTIVITATEA DE NTREPRINZTOR
3. Ai ncercat vreodat s deschidei o afacere proprie?
Da Nu
Dac da, n ce domeniu? _______________________________________________
4. La moment avei o afacere proprie?
Da Nu
5. Dac intenionai s ncepei/extindei o afacere, ce domeniu ai alege? ( De ce? )
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________

6. Care este echipamentul/utilajul de care avei nevoie pentru a ncepe/extinde afacerea proprie?
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
7. Estimai suma de bani necesar iniierii/extinderii afacerii? ____________________________________
______________________________________________________________________________________
8. Suntei, la moment, beneficiar de remitene? (bani din strintate)
Da
Nu
Dac da, indicai disponibilitatea DVS de a investi o parte din acetea n iniierea sau extinderea unei
afaceri ?
______________________________________________________________________________________
9. Localitatea unde dorii s desfurai activitatea economic_____________________________________
10. Avei cas, apartament, teren sau alt local necesar iniierii/extinderii afacerii?
Da
Nu
11. La ce programe/cursuri/seminare de dezvoltare antreprenorial ai mai participat?
Programul/Cursul

Perioada

12. Ai elaborat un plan de afaceri?

Da
Nu
13. De ce sprijin credei c avei nevoie pentru a ncepe/extinde o afacere proprie?
Instruire general n domeniul afacerilor

Consultan juridic
Consultan financiar-contabil
Consultan n marketing
Consultan n management
Alt gen de sprijin (specificai) _________________________________________________
_____________________________________________________________________________________
______________________________________________________________________________________
14. Pn n prezent, ai solicitat o finanare sau un credit?
Da
Nu
Dac da, care a fost rezultatul solicitrii _______________________________________________
15. Ce v-ai propus s obinei n urma participrii la acest Program? _______________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Localitatea unde dorii s participai la cursuri: ________________________________________________

Data____________

Semntura aplicantului: _____________