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M1_CNU_cerere completare de norm n unitate_perioada nedeterminata

Nr. ___________ /_______2015


Verificat exactitatea datelor
Director,
______________________________________________

Domnule Director,
Subsemnatul(a) (iniiala tatlui)___________________________________________________________________________
__________________________________________________________________________________________________________,
______________________________________________nscut() la data de __________________________________________,
COD NUMERIC PERSONAL:
cu domiciliul n localitatea______________________________________________________________________________________
_________________________________________________________________________________________________,
strada
_____________________________________________________, nr.____, bl.____, scara _____, ap.______, judeul (sect.)
____________________________,TELEFON ___________________, posesor al B.I. / carte de identitate seria _______,
nr.__________, eliberat() de Poliia ______________________________________, la data de _______________, prin prezenta
v solicit completarea normei didactice de predare-nvare-evaluare pe perioad nedeterminat, ncepnd cu
01.09.2015, cu ore de _______________________ , n conformitate cu prevederile art. 25 din Metodologia-cadru privind
mobilitatea personalului didactic din nvmntul preuniversitar n anul colar 2015-2016, aprobat prin OMEN nr.
4895/2014, cu modificarile i completrile ulterioare.
Menionez urmtoarele:
1. Sunt titular() pe/la postul/catedra de __________________________________________, de la (unitatea/unitile
de
nvmnt)_______________________________________________________________________________________________,
localitatea_________________________________________________________________________________________________, judeul
(sect.) ___________________________, din anul _______ .
2. Sunt absolvent() al (a) (Univ., Institutului, Academiei, I.P. 3 ani, Colegiului, c. postliceale, c. de maitri,
etc.)_______________________________________________________________________________________________________
__________________________________________________________________________________________________________
Facultatea ______________________________________________________________________________________ nivelul studiilor
(medii, postliceale, universitare de scurt durat, ciclul I de studii universitare de licen, ciclul II de studii
universitare
de
masterat,
universitare
de
lung
durat)__________________________________________________________________________
___________________________________________________________________________________________________________
________________________________________________________, cu durata studiilor de _____ ani (zi sau i.f., seral, f.r., f.f.,
i.d.), promoia ________, cu specializarea principal_______________________________________________________________
____________________________________________________________________________________________________________________
__________________________________________________________________________________________,
secundar
______________________________________________________________________________________ cu media de absolvire a
studiilor ____________; absolvent() al(a) cursurilor postuniversitare_________________________________________
____________________________________________________________________________________________________________________
_____________________________________________________________________________________________, cu durata studiilor de
_____ ani, specialitatea_______________________________________________________________, promoia _________ cu media
de absolvire ______________.
3. Am obinut definitivatul n anul________, cu media __________, gradul II n anul ________, cu media
___________, gradul I
n anul ________, cu media __________, doctoratul n anul _______, n
specialitatea___________________________
_______________________________________________________________________________________________________.
4. La 1 septembrie 2014 am avut __________ ani ntregi vechime n nvmnt.
5. Am beneficiat de continuitate pentru completarea normei didactice la nivelul unitii, dup cum urmeaz:

Un numr de __ ore de _________________________________________________ n anul colar 20122013;

Un numr de __ ore de _________________________________________________ n anul colar 20132014;

Un numr de __ ore de _________________________________________________ n anul colar 20142015;

Rspund de exactitatea datelor nscrise n prezenta cerere i declar c voi suporta consecinele n cazul unor
date eronate.

Data _____________________

Semntura___________________