ACCOMMODATION FORM

(Cerere de cazare)

ACADEMIC YEAR 2022-2023 PHOTO

(Anul universitar 2022– 2023)

1st semester full academic year

Semestrul I tot anul academic

I. PERSONAL INFORMATION (DATE PERSONALE)

Full Name: Burdianov Marian

(Numele
complet)
Gender: Female Male
(Sex)
Date of birth: Place of birth: Orhei, Moldova
(Data naşterii) 02.04.2001 (Locul naşterii)

Father’s forename: Pren Mother’s forename: Lidia

(Prenumele tatălui) Marian (Prenumele mamei)

Full address:
Satul Seliște, raionul Orhei, Moldova
(Adresa)

Phone number (Telefon):

+37367182001
ID card serial number
(Seria / numărul actului de B27047668
identitate)

II. STUDY INFORMATION (DATE CU PRIVIRE LA STUDII)

I am a student at the University of Universitatea din București

(Sunt student la Universitatea)
Country:
România
(Ţara)
I, undersigned, Burdianov Marian from Republica Moldova aware about the General Data Protection Regulation
(‘GDPR’), I give my full consent to the University of Bucharest to collect and process my personal information for the
purpose of accommodation formalities.I am aware that the information, known as ‘Personal Data’, includes, but is not
limited to my name, address, telephone number and email address.
Date: Signature: (Data)
(Semn ătura)

For IRO of UB only (do not fill in):

ACCOMMODATION COMMITTEE DECISION (DECIZIA COMISIEI DE CAZARE)
Accommodation granted in dormitory ..................... building C, room no. ...........................
(Se aprobă cazare în căminul ..............................., camera .........................)