Nr.

___________ /_______2011
Pentru concursul din 13 iulie 2011,
__________________________________________
(pentru cadrele didactice titulare participante la concurs
Pentru concursul de suplinire din 4 august 2011,
pentru managementul resurselor umane
__________________________________________

Viza Oficiului Juridic

________________________________________________

Domnule

,
e/catedrelor vacante/rezervate din 13 iulie 2011 /
concursul pentru suplinire din 4 august 2011 )

____________________________________________________________________________
____________________________________________________________________
COD NUMERIC PERSONAL:
1)
a) Univ., Institutul, Academia, I.P. 3 ani, Colegiul
tri, Lic. Ped. etc. _____________________________________
_________________________________________________________________________________________________________________,
Facultatea
___________________________________________________________________________________________________
ciclul II de studii universitare de
masterat,
_________________________________________________________________________________
_________________________________________________________________________________________________________________,
cu durata studiilor de _____ ani (zi, seral, f.f
area princi
___________________________________
_____________________________________________________________________________________________
_________________________________________________________________________, cu media la examenul de s
________________________, media de departajare (*) _______________________;
b) Univ., Institutul, Academia, I.P. 3 ani, Colegiul
_________________________________________________________________________________________________________________,
Facultatea
___________________________________________________________________________________________________
nivelul studiilor (medii, postliceale, univer
ciclul II de studii universitare de
masterat,
_________________________________________________________________________________
_________________________________________________________________________________________________________________,
cu durata studiilor de _____ ani (zi, seral, f.f
ar
___________________________________
_____________________________________________________________________________________________
_________________________________________________________________________,
________________________, media de departajare (*) _______________________;
c) Univ., Institutul, Academia, I.P. 3 ani, Colegiul
_________________________________________________________________________________________________________________,
Facultatea
___________________________________________________________________________________________________
ciclul II de studii universitare de
masterat,
_________________________________________________________________________________
_________________________________________________________________________________________________________________,
cu durata studiilor de _____ ani (zi, seral, f.f
ar
___________________________________
________________________________________________________________________________________________________,
_________________________________________________________________________,
________________________, media de departajare (*) _______________________;
2)
cursuri postuniversitare (studii aprofundate,
studii academice postuniversitare, studii postuniversitare de specializare)
Univ., Institutul, Academia)_______________________________________________________________________________,
________________________________________________________________________________________________________________,
cu specializarea ___________________________________________________________________________, cu durata studiilor de _____
__________ ;
Univ., Institutul, Academia)_______________________________________________________________________________ ,
________________________________________________________________________________________________________________,
cu specializarea ___________________________________________________________________________, cu durata studiilor de _____
_, media de absolvire _______, media de departajare(*) _____________ ;
Univ., Institutul, Academia)_______________________________________________________________________________ ,
________________________________________________________________________________________________________________,
cu specializarea ___________________________________________________________________________, cu durata studiilor de _____
__________ .
3)
ciclului I de studii universitare de
am absolvit studii postuniversitare de specializare,
Univ., Institutul, Academia)_______________________________________________________________________________,
________________________________________________________________________________________________________________,
cu specializarea ___________________________________________________________________________, cu durata studiilor de _____
__________ ;
Univ., Institutul, Academia)_______________________________________________________________________________ ,
________________________________________________________________________________________________________________,

127

cu specializarea ___________________________________________________________________________, cu durata studiilor de _____

_______, media de departajare(*) _____________ ;
Univ., Institutul, Academia)_______________________________________________________________________________ ,
________________________________________________________________________________________________________________,
cu specializarea ___________________________________________________________________________, cu durata studiilor de _____
__________ .
4) La 1 septembrie 2010
5) La data depunerii dosarului am definitiv
gradul didactic II
gradul didactic I (doctorat echivalat cu gradul didactic I) cu media
6)
7)
a)

10/2011
stul/ catedra _____________________________________________________________, de la unitatea
de
________________________________________
_________________________
localitatea__________________________________________________________________________

b) Suplinitor(oare) pe/la postul/catedra de ________________________________________________________________ de la

unitatea
____________________________________________________________________________________
________________________________________________________________________________________________________ localitatea
________________________________________________________________
______________________;
c)
______________________
_______________________________, localitatea ________________________________________________________________________,
,
__________________________________________________________________________________.
3 iulie 20 11
de____________________________________________________________________________________________________________
_________________________________________________________________________________________________________________,
prin titularizare/ transferare/
/rezervate, la
t
notelor la
practice/orale:
_______________________________;
_______
3 _______________________________________________;
____________________________________________________________________________________
_________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________.
_______________________________________________________.
concursului pentru suplinire din 4 august 2011
practice/orale:
______;
3 _______________________________________________;
la disciplina____________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________.
8)
5 31.08.2011
5-2006
de ___________ ___________________de la _______________________________.
An
6-2007
de ______________________________ de la _______________________________.
7-2008
de ______________________________ de la _______________________________.
8-2009
de ______________________________ de la _______________________________.
9-2010
de ______________________________ de la _______________________________.
10-2011
de ______________________________ de la_______________________________.
9)
prin Decizia nr. __________, conform art. _______, din Codul Muncii.
10) Prezint avizul medical nr. _____ / ______2011
decl
pentru motive disciplinare sau printr-

media examenului de stat

anilor de studiu.

128

9-2010 (actele nr. 2, 3, 4, 5, 6, 7, 8):

1) Copii legalizate de p
11
ea
2
-au schimbat numele);
5) Decizia inspectora
6) Copie de pe fila din B.I. sau cartea de identitate cu domiciliul;
8) Copie de pe carne
sau printr-

11
discipline a catedrei,
31.08.20

), precum

OSTURI
3 iulie 2011, accept
11

Localitatea
Sectorul

Data_______________
VERIFICAT

129

Post/catedra
Nr. ore

Nr. ___________ /_______2011

Pentru sesiunea iulie 2011,
__________________________________________
(pentru cadrele didactice titulare participante la concurs
Pentru sesiunea august 2011,
Inspe
pentru managementul resurselor umane
__________________________________________
e)

Viza Oficiului Juridic

________________________________________________

Domnule

de _____________19_____,

pe(la) postul (catedra) de ____________________________________________________

_____________________________________________________________________________________________________,

localitatea
-

11 pe(la) un pos

(1)

2010-2011

I. Am d
___________________________ nr. ________, bloc _________, ap. _________, TELEFON:______________________; conform actului de
identitate _____seria ________nr. __________________eliberat de __________________________;
COD NUMERIC PERSONAL
II.
al(a) (Univ., Academiei., Institutului, I.P.-3 ani, Colegiului
ped.)____________________________________________________________________________________________________ Facultatea
_________________________________________________________________________________________________________________
nivelul studiilor (medii, postliceale, universita
I de studii universitare de
masterat,
_________________________________________________________________________________
_________________________________________________________________________________________________________________,
_cu specializarea____________________________________________________________________
________________________________________________________________________________
______________________________________________________________________________ (2).
P ____,_____
- Facultatea _____________________________________________, cu durata studiilor de ______ani (curs zi; ser
specializarea______________________________________________________________________________
- Studii postuniversitare de specializare cu durata de _____semestre

(2)

P ____,_____

_______________________________
P ____,_____

- Studii academice postuniversitare cu durata de _____semestre

(2)

___________________________________

- Studii aprofundate de specialitate cu durata de _____semestre

(2)

___________________________________

P ____,_____
P ____,_____

- Masterat

___________________________________________________________
(2)

P ____,_____
______________________________

P ____,_____
- Studii pos
(2)___________
______________________________________________________________________________________________
P ____,_____
- Studii aprofundate de specialitate, cu
(2)________
___________________________________________________________________________________________
P ____,_____
2
)____________________
absolvirea
__________________________________________________________________________________________________
P____,_____
III. La data depunerii dosarului: sunt
cu media_______; am
cu media ___________;
media__________;
cu media ________;
specialitatea _____________________________________;
ene, urmat de
specializarea ______________________________________________________________________
(pentru antrenori)
IV.
8/2009_________________________
9/2010 _________________________;

130

cu

P ___,_____
P____,_____

V.1.
la ni

(3)
(4)

31.08.2010

(4)

(4)

P ______,______, la nivel

P _______,___________ .

V.2.

endaristici (la data depunerii dosarului) am participat,

Elaborarea
Elaborarea
Elaborarea
Elaborarea
Elaborarea
ISSN;
Elaborarea
Elaborarea

, pentru:

de
de
de
de
de

, Tineretului Sportului;
, Tineretului Sportului;

aprobate de

P ____,____
P____,____
P____,____
P____,____

/
sau alte auxiliare curriculare / de sprijin;

de
de

, Tineretului

V.3.
AEL, PhareV.4 .

coordonate de

Sportului;
, Tineretului
e anterior;
;

P____,____
P____,____
P____,____
Sportului (formator
P____,____
P____,____

V.5.
, Tineretului

Sportului
P____,____
P____,____

VI. La 01.09.2010

TOTAL PUNCTAJ( 5) :
VII. Criteriile social

P ________ , ________

umanitare (Da / Nu): a) ______ b) ______ c) _____ d) ______ e) ______f)______.

3) Documente cu confirmare
Pentru cadrele
la care
VIII.
-

5 31.08.2011
5-2006
de ___________ ___________________de la _______________________________.
6-2007
de ______________________________ de la _______________________________.
7-2008
de ______________________________ de la _______________________________.
8-2009
de ______________________________ de la _______________________________.
9-2010
de ______________________________ de la_______________________________.
-2011
de ______________________________ de la _______________________________.

IX.
Codul Mu

eronate.
Data________________

_____

131

2. Copia xerox a actu

3. Copii legalizate
4

.
, de pe certificatele de grade
olari 2008/2009

9/2010
justificative.

articolelor publicate, documentele prin care s8. Copii ale

conti

.
.
5

31.08.2011

, din car
-umanitare.
ctiv din

**)
nr.______________, eliberat d
pe(la) postul / catedra:

OPTEZ
Post/catedra (Nr. ore)

11
Localitatea

_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________

Data_________________

132