Application Form Call: 2017, 1 - Leaning Mbit oda Erasmus+ A101 - Schoo education staff mobity = my organisation and the other partner organisations herein, to take part upon request in dissemination and exploitation activities. conducted by National Agencies, the Executive Agency and/or the European Commission, where the participation of individual. Participants may also be required. | acknowledge that administrative and financial penalties may be Imposed on the organisation | represent if it is guilty of rmistepresentation or is found to have seriously falled to meet its contractual obligations under a previous contract or grant award procedure. Place: VASLUI Date (dd-mem- yyy: Name ofthe appcantorgansaton: GLNGIMITA CU PROGLAM PRELUNGIT, CASTELUL CoPuLoR Name of legal representative: Ste E LE NUTA- Signature: WWlo-re— National ID number of the signing person (if requested by the National Agency): 600604 3440 9F © ‘Stamp of the applicant organisation (if applicable): x COPIILOR Gir: 2m6t0a9 Sas Form hash code: SS97CRCO7739658. TEN] Formhasnot been submited yet Page sof 36