Subsemnatul (a) ____________________________________________ , student () a
facultii _____________________, anul de studiu ____, seria _____, grupa ______, n vederea evalurii finale optez pentru urmtoarea tem (titlul complet al temei + numrul de ordine din list): ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________
Date de contact: Email: ______________________________________
Tel (fix / mobil): ________________________________
Solicit ca ndrumtor tiinific pentru elaborarea temei pe doamna / domnul (cadru
didactic al D.P.P.D.): __________________________________