Coordonat: Aprobat:

Președintele comisiei metodice Director

____________________________
________________________
(denumirea comisiei metodice)
(nume, prenume)
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_______________________
(nume, prenume, semnătură)
(semnătura)
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Curriculum modificat la
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(disciplina de studiu)
Elev _______________________________________________________________________

Clasa ______________________________________________________________________

Perioada de realizare ________________________________________________________

Profesor ___________________________________________________________________
(nume, prenume)