Aviz ef disciplin/catedr

(pentru medici rezidenti, doctoranzi)

Nr. nregistrare

Aviz Coordonator Erasmus

Aviz Decan
Aviz Consiliu de Administratie

DOMNULE RECTOR
Subsemnatul (a)__________________________________________________________
student

anul

_________________________

Facultatea_____________________________

U.M.F. Grigore T. Popa Iai, v rog s-mi aprobai deplasarea la Universitatea

___________________________Tara/orasul______________________in cadrul programului
ERASMUS + in perioada ____________________ inclus in acordul bilateral pentru anul
academic 2015-2016.
Solicit din partea U.M.F. Gr.T.Popa Iai ____________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Anexez copii dup: invitaie
Ma angajez ca la intoarcerea in tara sa prezint la Decanatul / Rectoratul U.M.F. Iasi un raport
asupra acestei deplasari.
Argumente privitoare la impactul deplasrii asupra obiectivelor prioritare:
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Data ___________________________

Semntura_____________________

Domnului Rector al U.M.F. Gr.T.Popa Iai

Pag 1din 1

FP12-06, ver 2

Viza de control financiar preventiv ,

Viza contabilitate,

Domnule Rector,
Subsemnatul (a)__________________________________________________________
student

anul

U.M.F.

_________________________

Grigore

T.

Popa

Iai,

Facultatea_____________________________

privitor

la

deplasarea

__________________________Tara/orasul______________________in

la

Universitatea

cadrul

programului

ERASMUS + in perioada ____________________, cheltuielile legate de aceasta deplasare vor fi

acoperite dupa cum urmeaza:
transportul intern si international pe ruta:
..........................................................................................................................................................
cu (mijloacele de transport) ..............................................................................................................
in suma de
lei ................................................................ valuta .........................................................
va fi suportat de
...........................................................................................................................................................
Cheltuielile de intretinere in strainatate vor fi suportate de: .............................................................
...........................................................................................................................................................
diurna
..........................................................................................................................................................
cazarea
...........................................................................................................................................................
taxa de viza + asigurare medicala
...........................................................................................................................................................
TOTAL CHELTUIELI (in limita sumei de) ....................................................................................
Ma angajez ca la intoarcerea in tara, odata cu decontul de cheltuieli, sa prezint si raportul privind
deplasarea efectuata.
..............................................
(Semnatura)
Pag 2 din 2

FP12-06, ver 2