MONITORUL OFICIAL AL ROMÂNIEI, PARTEA I, Nr.722/24.X.

2012
ANEXA.Nr.2*)
Antetul Universităţii
FOTO
3x4

CERERE PENTRU ELIBERAREA SCRISORII DE ACCEPTARE LA STUDII

(DEMANDE D’APPLICATION POUR LA LETTRE D’ACCEPTATION AUX ÉTUDES)
(Se completează cu majuscule/ to be filled in with capital letters/ A completer en majuscules)

1. NUMELE: NGUYEN PRENUMELE: TRUNG HIEU

(SURNAME/NOMS) (GIVEN NAMES/PRENOMS)

2. NUMELE PURTATE ANTERIOR: None

(PREVIOUS SURNAMES/NOMS PORTE ANTERIEUREMENT)

3. LOCUL SI DATA NASTERII Tara: Vietnam Localitatea: Quang Binh Data 2 7 0 3 1 9 8 7

(DATE AND PLACE OF BIRTH/ (COUNTRY/PAYS) (PLACE/LOCALITE) (DATE/DATE)
DATE ET LIEU DE NAISSANCE Z Z L L A A A A
(D D M M Y Y Y Y)
4. PRENUMELE PARINTILOR: Father’s given name: HAO Mother’s given name: GIANH
(PARENTS GIVEN NAMES/PRENOMES DES PARENTES)

5. SEXUL (SEX/SEXE): Male

6. STAREA CIVILA : CASATORIT(A) NECASATORIT(A) DIVORTAT (A) VADUV(A)

(MARRIED/MARIE)
X (SINGLE/CELIBATAIRE) (DIVORCED/DIVORCE) (WIDOW9ER)/VEUV(VEDF))

7.CETATENIA (CETATENIILE) ACTUALE: Vietnamese CETATENII ANTERIOARE: None

(ACTUAL CITIZENSHIP(S)NATIONALITE(S) ACTUELE(S)) (PREVIOUS CITIZENSHIPS/NATIONALITES ANTERIEURES)

8. DOCUMENT DE CALATORIE : TIPUL: Passport SERIE__________C______________ NR: 2768557

(TRAVEL DOCUMENT/DOCUMENT DE VOYAGE) (TYPE/TYPE) (SERIE/SERIE) (NO/NO)

ELIBERAT DE TARA: Vietnam LA DATA 0 2 0 3 2 0 1 7 VALABILITATE: 02.03.2027

(COUNTRY ISSUED BY/ EMIS PAR PAYS) (DATE OF ISSUE/A) (VALIDITY/EXPIRANT LE)

9. DOMICILIUL PERMANENT ACTUAL : TARA: Vietnam LOCALITATEA: Hoan Lao town, Bo Trach district, Quang Binh province
(ACTUAL PERMANENT RESICENCE/DOMICILE (COUNTRY/PAYS) (PLACE/LOCALITE)
PERMANENT ACTUEL)

10. PROFESIA: Lecture LOCUL DE: Hue College of Arts, Vietnam

(PROFESSION/PROFESSION) (WORK PLACE/ LIEU DE TRAVAIL)

11. MOTIVATIA DEPLASARII IN ROMANIA (PURPOSE OF VISIT/BUT DE SEJOUR)

 STUDII (ÉTUDES)
 MONITORUL OFICIAL AL ROMÂNIEI, PARTEA I, Nr.722/24.X.2012

I.Education Background
1. Secondary education
Name and Location of the Secondary School: Bo Trach Secondary school, Bo Trach district, Quang Binh
province, Vietnam
Date of Admission / Date of Completion: September 5, 2002 / June 6, 2005
Type of Certificate issued: Graduation certificate
2. Undergraduate education
Name and Location of the University: Hue College of Arts, Vietnam
Date of Admission / Date of Completion: September, 2006 / July, 2010
Type of Certificate issued: Degree of University Bachelor of Art - Education

II. Studies applied in Romania/University/Language of instruction

a) pre-university, in the grade: University of Pitești/ Romanian language course/Language of Instruction:
Romanian
b) undergraduate, in the branch:
c) postgraduate - master, in the branch/: National University of Arts Bucharest, in Fine Arts/Language of
Instruction: Romanian
- specialization, in the branch:
- doctorate, in the speciality:
III. Proficiency in other languages ( please, fill in as appropriate: excellent, good, poor )
Language Writing Speaking
Romanian : Poor Poor
English: Good Good
Vietnamese: The first language

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 al 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. Annexes (authenticated translations of the respective documents in a language widely spread

internationally)
1. Photocopies et traductions légalisées des certificats d’études;
2. La liste complète des résultats des études pour chaque année, pour les solliciteurs des études
postuniversitaires et
pour les étudiants qui désirent se transférer d’un autre pays (photocopies et traductions légalisées).
3. Photocopie et traductions légalisée de l’acte de naissance;
4. Photocopie du passeport;
5. Certificat médical (traductions légalisées dans une langue de circulation internationale).

On my arrival in Romania I should submit the original documents.

Date: 27.04.2017 Signature …………………….

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AUTHORITY ONLY RESERVE AUTORITES