Cerere de ncadrare n anul colar 2017-2018 n sistemul de PLATA CU ORA/CUMUL

Nr. ___________ /_______2017

Se certific exactitatea datelor
De acord,
DIRECTOR
Inspector colar pentru managementul resurselor umane
L.S. __________________________
______________________________________________
(Numele i prenumele)
(Numele i prenumele)

Domnule Inspector colar General / Domnule Director,

Subsemnatul(a) numele, (iniiala tatlui), prenumele ________________________________________________________

__________________________________________________________________________________________________________,

COD NUMERIC PERSONAL:

nscut() la data de _________________________________________, cu domiciliul n localitatea________________________

_______________________________________________________________, judeul (sectorul)_________________________,
str.___________________________________________________, nr. ____, bl._____, sc.____, ap.____, TELEFON
_______________________, posesor(oare) al B.I./C.I. seria _______, nr.__________, eliberat() de Poliia______________, la
data de ________, v rog s-mi aprobai ncadrarea n anul colar 2017-2018 n sistemul de PLATA CU ORA pe/la postul/catedra
de________________________________________________________________________________________________________
______________________________________________________________________________________________________ de la
(grdinia, coala, liceul, grupul colar, colegiul etc.)_________________________________________________________
____________________________________________________________________________________________ din localitatea
______________________________________________________________, judeul (sectorul) _________________________
pentru care AM/NU AM acordul consiliului de administraie al unitii de nvmnt*.

Prezint urmtoarea situaie:

1) Studii finalizate cu examen de absolvire/licen/bacalaureat:
a) Univ., Institutul, Academia, I.P. 3 ani, Colegiul, c. postliceal, c. de maitri, Lic. Ped. etc._________________
______________________________________________________________________________________________, Facultatea
______________________________________________________________________________ nivelul studiilor (medii, postliceale,
universitare de scurt durat, ciclul I de studii universitare de licen, universitare de lung durat, ciclul II de studii universitare de
masterat)__________________________________________________________________________________________________
_________________________________________________________________________________________________, cu durata
studiilor de _____ ani (zi, seral, f.r., id) promoia ____________ cu specialitatea principal_____________________________
__________________________________________________________________________________________________________
________________________________________________________, secundar_________________________________________
_____________________________________, cu media la examenul de stat (licen)/absolvire ____________________________;

b) Univ., Institutul, Academia, I.P. 3 ani, Colegiul, c. postliceal, c. de maitri, Lic. Ped. etc.____________________________
_________________________________________________________________________________________________, Facultatea
_________________________________________________________________________ nivelul studiilor (medii, postliceale,
universitare de scurt durat, ciclul I de studii universitare de licen, universitare de lung durat, ciclul II de studii universitare de
masterat)__________________________________________________________________________________________________
_________________________________________________________________________________________________, cu durata
studiilor de _____ ani (zi, seral, f.r., f.f, id) promoia _____________________________ cu specialitatea
principal___________________________________________________________________________________________________
__________________________________________________________________________________________________________
___________________________________________, secundar______________________________________________________
____________________________________________, cu media la examenul de stat (licen)/absolvire______________________;

c) Univ., Institutul, Academia, I.P. 3 ani, Colegiul, c. postliceal, c. de maitri, Lic. Ped. etc.____________________________
_________________________________________________________________________________________________, Facultatea
___________________________________________________________________________ nivelul studiilor (medii, postliceale,
universitare de scurt durat, ciclul I de studii universitare de licen, universitare de lung durat, ciclul II de studii universitare de
masterat)__________________________________________________________________________________________________
__________________________________________________________________________________________, cu durata studiilor
de _____ ani (zi, seral, f.r., f.f, id) promoia ______ cu specialitatea principal________________________________________
_______________________________________________________________________________________________________,
secundar_______________________________________________________________________________________________
_______________________________________________________________, cu media la examenul de stat (licen)/absolvire
____________________________;

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 2) Dup absolvirea cu diplom de licen a studiilor universitare de lung durat/ciclului II de studii universitare de
masterat am absolvit studii postuniversitare (studii aprofundate, studii academice postuniversitare, studii postuniversitare de
specializare) cu durata de minimum 3 semestre (1,5 ani), dup cum urmeaz:
a) Instituia ( Univ., Institutul, Academia)______________________________________________________________________
__________________________________________________________________________________________, cu specializarea
___________________________________________________________________________, cu durata studiilor de _____ ani,
promoia _______, media de absolvire ____________ ;

b) Instituia ( Univ., Institutul, Academia)______________________________________________________________________

__________________________________________________________________________________________, cu specializarea
___________________________________________________________________________, cu durata studiilor de _____ ani,
promoia _______, media de absolvire ____________ ;

c) Instituia ( Univ., Institutul, Academia)______________________________________________________________________

__________________________________________________________________________________________, cu specializarea
___________________________________________________________________________, cu durata studiilor de _____ ani,
promoia _______, media de absolvire ____________.

3) Alte studii absolvite cu diplom:

- Studii postuniversitare de specializare cu durata de _____semestre (2) _______________________________
- Studii academice postuniversitare cu durata de _____semestre (2) ___________________________________
- Studii aprofundate de specialitate cu durata de _____semestre (2) ___________________________________
- Masterat n sistem postuniversitar _____________________________________________________________

- Cursuri de perfecionare postuniversitare cu durata de _____semestre (2) ______________________________

- Studii postuniversitare de specializare, academice postuniversitare cu durata mai mic de 3 semestre________
___________________________________________________________________________________________

- Studii aprofundate de specialitate, cursuri de perfecionare postuniversitar cu durata mai mic de 3 semestre
_________________________________________________________________________________________
- Dup absolvirea ciclului I de studii universitare de licen am absolvit studii postuniversitare n domeniul ( 2)
__________________________________________________________________________________________

4) Am obinut definitivatul n anul ________, gradul II n anul ________, gradul I n anul __________, doctoratul n anul
_________, n specialitatea ____________________________________________________.
5) Sunt ncadrat() cu contract de munc pe perioad nedeterminat (determinat) la
______________________________________________________ judeul (sectorul) ________________, pe/la postul/catedra
(funcia) de ____________________________________________________________________________________________
_______________________________________________________________________________________________________.
6) n anul colar 2016-2017 am fost ncadrat() n sistemul de PLATA CU ORA/CUMUL pe/la postul/catedra (vacant(),
rezervat())_________________________________________________________________________________________________
_______________________________________________________________, avnd n ncadrare un numr de ____ore, de
la______________________________________________________________________________________,
__________________, localitatea __________________________, judeul (sectorul) ____________________, obinnd la sfritul
anului colar calificativul ________________________________ i AM/NU AM recomandarea Consiliului de administraie al unitii
de nvmnt pentru continuitate n anul colar 2017-2018.

7) CALIFICATIVUL obinut n anul colar 2014/2015_________________________

i n anul colar 2015/2016 _________________________;

NOT: a) Pentru absolvenii promoiei 2016 i debutanii n primul an de activitate se ia n considerare calificativul parial din anul colar
2016-2017.
b) Pentru absolvenii promoiei 2015 i debutanii n al doilea an de activitate se iau n considerare calificativul pentru anul colar 2015-2015 i
calificativul parial din anul colar 2016-2017.
c) n cazul ntreruperii activitii la catedr, n perioada ultimilor doi ani colari, se iau n considerare calificativele pentru ultimii doi ani colari n
care cadrul didactic i-a desfurat activitatea.

8) La 01.09.2016 am _____ ani _______ luni, vechime efectiv la catedr (inclusiv perioada rezervrii catedrei).

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