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CERERE PENTRU ELIBERAREA SCRISORII DE ACCEPTARE LA STUDII
(APLICATION FOR THE ISSUANCE OF LETTER OF ACCEPTANCE TO STUDIES)
(Se completează cu majuscule/to be filled
with capital letters/A completer en majuscules)
1. NUMELE _______________________________________ PRENUMELE _______________________________________
(SURNAME/NOMS) (GIVEN NAMES/PRENOMS)
2. NUMELE PURTATE ANTERIOR ________________________________________________________________________
(PREVIOS SURNAMES/NOMS PORTE ANTERIEUREMENT)
┌─┬─┬─┬─┬─┬─┬─┬─┐
3. LOCUL ŞI DATA NAŞTERII Ţara ___________ Localitatea __________ Data └─┴─┴─┴─┴─┴─┴─┴─┘
(DATE AND PLACE (COUNTRY/PAYS) (PLACE/LOCALITE) (DATE/DATE) Z Z L L A A A A
OF BIRTH/ (D D M M Y Y Y Y)
DATE ET LIEU DE
NAISSANCE)
4. PRENUMELE PĂRINŢILOR ________________________________________________________
(PARENTS GIVEN NAMES/PRENOMES DES PARENTES)
5. SEXUL (SEX/SEXE): M F
6. STAREA CIVILĂ ┌─┐ CĂSĂTORIT(Ă) ┌─┐ NECĂSĂTORIT(Ă) ┌─┐ DIVORŢAT(Ă) ┌─┐ VĂDUV(Ă)
└─┘ (MARRIED/MARIE) └─┘ (SINGLE/CELIBATAIRE) └─┘ (DIVORCED/ └─┘ (WIDOWER/
DIVORCE) VEUVE(VEUF))
7. CETĂŢENIA (CETĂŢENIILE) ACTUALE ________________________________ CETĂŢENII ANTERIOARE
(ACTUAL CITIZENSHIP(S)/NATIONALITY(S) ACTUELES(S)) (PREVIOS CITIZENSHIPS/
NATIONALITES ANTERIEURES)
8. DOCUMENT DE CĂLĂTORIE: TIPUL _____________________ SERIE __________________ NR. _________
(TRAVEL DOCUMENT/ (TYPE/TYPE) (SERIE/SERIE) (NO/NO)
DOCUMENT DE VOYAGE)
ELIBERAT DE ŢARA: ____________________ LA DATA ┌─┬─┬─┬─┬─┬─┬─┬─┐ VALABILITATE __________
(COUNTRY ISSUED BY/ (DATE OF ISSUE/A) └─┴─┴─┴─┴─┴─┴─┴─┘ (VALADITY/EXPIRANT LE)
EMIS PAR PAYS)
9. DOMICILIUL PERMANENT ACTUAL : ŢARA _____________________ LOCALITATEA __________________
(ACTUAL PERMANENT RESIDENCE/ (COUNTRY/PAYS) (PLACE/LOCALITE)
DOMICILE PERMANENT ACTUEL)
10. PROFESIA ___________________________ LOCUL DE MUNCĂ _____________________________
(PROFESSION/PROFESSION) (WORK PLACE/LIEU DE TRAVAIL)
11. MOTIVAŢIA DEPLASĂRII ÎN ROMÂNIA (PURPOSE OF VISIT/BUT DE SEJOUR)
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I. Education Backgroud
1. Secondary education
Name and Location of the Secondary School ......................................
Date of Admission/Date of Completion ...........................................
Type of Certificate issued .....................................................
II. Studies applied in Romania/University/Language of instruction
a) pre-university, in the grade ................................................
b) undergraduate, in the branch ................................................
c) postgraduate - master, in the branch ........................................
- specialization, in the branch ................................
- doctorate, in the speciality .................................
III. Proficiency in the languages (please, fill in as appropriate: excellent, good, poor)
Language Writing Speaking
Romanian .......................................................................
................................................................................
IV. Statement by the applicant
I oblige myself to observe the laws in force in Romania, the school and university rules,
regulations and norms, as well as those for social life.
I have taken note of the fact that school fees may be subject to change during the years
of study and must be payed, in free currency, in advance for a period of at least 10 month
for full time courses and at least 3 months for part time courses.
I am aware that any untrue information will lead to my disqualification.
V. Annex (authenticated translations of the respective documents in a language widely spread
internationally)
1. Photocopy or authenticated copy of the certificate of studies;
2. Authenticated copy of the birth certificate;
3. Authenticated copy of the passport;
4. Medical cartificate;
5. The list of result of the completed study years (Academic Transcripts) for postgraduate studies
applicants and for those wishing to continue begun in other countries.
On my arrival in Romania I should submit the original documents.
Date ..................... Signature .....................
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