Anexa nr.

2
la Regulamentul de conferire a
titlurilor i categoriilor sportive

foto

FIA DE CONFERIRE A TITLULUI DE ONOARE,

CATEGORIEI SPORTIVE

________________________________________________________________________
(denumirea titlului, categoriei)
Ramura de sport___________________________________________________________
Numele________________________________ Prenumele_________________________
Localitatea (municipiul/raionul)_______________________________________________
Anul naterii_______________ Sexul___________ Studii__________________________
Locul de munc, funcia_____________________________________________________
Asociaia sportiv__________________________________________________________
Vechimea n munc (arbitraj)_________________________________________________
Titlul (categoria) posedat(), anul conferirii _____________________________________
Domiciliu________________________________________________________________
Numele, prenumele antrenorului (pentru categorii sp.)_____________________________
Scurt referin:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

Directorul(eful) instituiei sportive _____________________

(semntura, tampila)

Date privind ndeplinirea condiiilor de conferire:

________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
 2

________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

CONFIRMARE:

eful Direciei municipale/raionale _______________ / ___________________________

(semntura) (Numele, prenumele)

____________________________ 200__

Federaia de profil _______________ / ___________________________

(semntura) (Numele, prenumele)

____________________________ 200__

Specialistul Ministerul Tineretului i Sportului _________ / _______________________

(semntura) (Numele, prenumele)

____________________________ 200__

Preedintele Comisiei _______________ / _______________________________

(semntura) (Numele, prenumele)

____________________________ 200__