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SCHOOL INDUSTRIAL GROUP “EMANUIL UNGUREANU “ TIMIŞOARA

300029, Timişoara, P-ţa. I. Huniade nr. 3


Tel. 0256493854 Fax 0356411540 eusescom@yahoo.com seseu.weebly.com

APPLICATION FORM

SYMPOSIUM WITH INTERNATIONAL PARTICIPATION


“CREATIVE AND MODERN EDUCATION IN THE SPIRIT”

TITLE OF THE
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SECTION:

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A
AUTHORS OF THE PAPER

NAME.............................................., LAST
NAME.....................................................................................................
SPECIALTY.............................................................................................
HOME
ADDRESS.............................................................................................................................
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FIXED/MOBILE
PHONE ................................................................................................................................
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E-MAIL...............................................................................................................................
SCHOOL.............................................................................................................................
CITY....................................................................................................................
COUNTY...........................................................................................................................
NAME.
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LAST NAME..............................................
SPECIALITY........................................................................................................................
HOME ADDRESS................................................................................................................
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FIXED/MOBILE
PHONE ...............................................................................................................................
E-MAIL....................................................................................................................
SCHOOL..................................................................................................................
CITY........................................................................................................
COUNTY...........................................................................................................................

TEACHER COORDINATOR (if applicable)..............................................................................

Facilities required for work (tick )


Computer (specify appropriate presentation program)
Projector
Other, specify:
Joined:: ................................................
Cont:RO93TREZ6215004XXX000237 TREZORERIA TIMIŞOARA
CHIT NO. ............../.................OR RECEIPT OF TRANSMISSION BY FAX : 0356411540