CERERE

de admitere la studii la Liceul Academiei

de tiine a Moldovei
Subsemnatul/Subsemnata: _______________________________________________________
Adresa domiciliu:
_______________________________________________________
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Instituia absolvit,
_______________________________________________________
adresa instituiei
_______________________________________________________
Tel. mob. de contact :
__________________e-mail:_______________________________
Rog s fiu nscris/nscris la concursul de admitere la Liceul Academiei de tiine a Moldovei
n clasa a_______-a, profilul
.
(real / umanist)

Aleg s fiu testat la disciplina (de subliniat o singur opiune):

Pentru profilul umanist:
Limba i literatura romn;
Pentru profilul real:
Biologia;
Chimia;

Istoria;
Fizica;

Matematica.

Suplimentar comunic:
Nota medie Certificat Studii Gimnaziale:
____________
Limba strin I (de baz), studiat n coal: _________________________ Nota: _________
Sunt deintor/deintoare al/a locului _______ la olimpiada raional / republican (subliniaz opiunea
corect) de ______________________ n anul _____________.
Alte performane personale: __________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
La cerere anexez urmtoarele copii:
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
Semnat: ______________________________________
Expediaz cererea completat la adresa e-mail: director.liceu@asm.md . La scurt timp vei
primi confirmarea recepionrii. Tel. de contact: 022 28 14 64