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Se aprob,

Director CEX,
Vasile Sorohan

CERERE DE PARTICIPARE

Subsemnatul(a), ________________________________________, profesor pentru nvmnt primar la


______________________________________________________ , v rog s-mi aprobai participarea la activitile
desfurate n cadrul Centrului de Excelen Iai, n anul colar 2015 2016, la matematic, nvmnt primar:
la clasa:
III IV

DATE PERSONALE ALE SOLICITANTULUI

Numele, iniiala tatlui i prenumele: _________________________________________________________


Data naterii: _____________________, localitatea ______________________, judeul ___________________
CNP ______________________________________
Domiciliul: localitatea _________________, strada _______________________ nr. _____, bloc ___________,
scara _____, apartamentul ____, telefon mobil ____________________, telefon la serviciu ___________________
e-mail __________________________________.
Studii:
Instituia de nvmnt: _________________________________________________, forma de nvmnt
absolvit: ZI / SERAL / FF / FR, anul absolvirii _________.

Gradul didactic ______, obinut n anul _________, gradaie de merit: DA NU

MOTIVAIA SOLICITRII
REZULTATE DEOSEBITE ALE SOLICITANTULUI
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________

Data: ______________ Semntura: _______________________

Str. Toma Cozma nr. 4, 700554, Iai


Tel: +40 (0)232 21 05 10
Fax: +40 (0)232 21 05 10