Formular TUIASI.POB.27-F1

Universitatea Tehnic "Gheorghe Asachi" din Iai

Aprobat,

Decan

DOMNULE DECAN

Subsemnatul, _____________________________________________________ ,

absolvent al ____________________________________________________________ ,

programul de studii universitare de master _________________________________________________________________________________________________________ ,promoia _____________ , v rog s-mi aprobai nscrierea la examenul de disertaie sesiunea _________________________________ .

Am mai susinut examenul de disertaie n anul _______________________ .

Am ntocmit lucrarea de disertaie cu titlul _____________________________

_______________________________________________________________________

_______________________________________________________________________

sub ndrumarea _________________________________________________________ .

Data: ________________

Semntura

____________________________

Viza ndrumtorului lucrrii

________________________

Media de colaritate (ECTS): ___________ Viz secretariat,

Domnului Decan al Facultii de ____________________________________________

Formular TUIASI.POB.27-F1, rev0