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Instituia Public

Universitatea de Stat de Medicin i Farmacie


Nicolae Testemianu

Asociaia Studenilor Farmaciti


din Republica Moldova

Cerere de nscriere
Nume i prenume: ___________________________
Cheptanari Nicoleta
Data naterii: _______________________________
15.01.2015
gr. 4206, anul II
Grupa/An de studii: __________________________

Numr de telefon: ___________________________


068177858
E-mail: ____________________________________
v_cheptanari@mail.md
Limbi strine: engleza,
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franceza, rusa
De ce vrei s fii membru ASFRM:
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Prin intermediul acestei
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Experienele anterioare de (voluntariat):
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Care din departamente i strnete interesul la prima vedere:
Departamentul tiin
Departamentul Cultur
Subdepartamentul Sport

Semntura ________________

Departamentul Proiecte
Departamentul Relaii Externe
Departament IT, Marketing, PR

Data ______ ______________ _______

Macari Doina 068394497