ANEXA 1MINISTERUL AFACERILOR EXTERN

ANEXA 1

MINISTERUL AFACERILOR EXTERNE – Direcţia Diplomaţie Publică, Culturală şi Ştiinţifică
MINISTERE DES AFFAIRES ETRANGERES – Direction Diplomatie Publique, Culturelle et Scientifique
MINISTRY OF FOREIGN AFFAIRS – Directorate Public Diplomacy, Cultural and Scientific


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CERERE DE BURSĂ PENTRU STUDII ÎN ROMÂNIA
DEMANDE DE BOURSE D’ETUDES EN ROUMANIE
APPLICATION FORM FOR SCHOLARSHIPS IN ROMANIA
(a se completa cu majuscule/A compléter en majuscules/
to be filled in capital letters)


ANUL ACADEMIC/ ANNEE UNIVERSITAIRE / ACADEMIC YEAR

2015-2016



TIPUL DE BURSĂ/ TYPE DE BOURSE/ SCHOLARSHIP TYPE:

 studii universitare de licenţă /études universitaires de licence/ Bachelor’s degree studies □
 studii de specializare / stages de spécialisation / Spécialisation courses □
 studii de masterat / études de master / Master studies □
 studii de doctorat / thèse de doctorat / PhD studies □


OPŢIUNI PENTRU INSTITUŢIA DE ÎNVĂŢĂMÂNT SUPERIOR (2 opţiuni)/
OPTIONS POUR L’ETABLISSEMENT D’ENSEIGNEMENT SUPÉRIEUR (2 options) /
OPTIONS FOR UNIVERSITIES (2 options) :


Oraşul / la ville / city Universitatea / l’université / university Facultatea / la faculté / faculty Specializarea/ la spécialisation / specialization profile







IDENTITATEA CANDIDATULUI / L’IDENTITE DU CANDIDAT / APPLICANT’S IDENTITY


Numele / Nom / Surname:………………………………………………….. ……………………………………….

Nume înainte de căsătorie/ Nom de jeune fille / Maiden Name: …………………………………………………

… ……………………………………………………………………………………………………………..

Prenume / Prénom / Name: ……………………………………………………………………………………….
Sexul/ Sexe/ Gender: M □ F □
Starea civilă/ Etat civil / Marital status: celibatar (ă)/ célibataire/single □
Căsătorit(ă) / marié (e)/ Married □ divorţat(ă) / divorcé (e) / divorced □
Naţionalitate / Nationalité / Nationality …………………………………….
Data naşterii / Date de naissance / Date of birth ………………………………………….
Locul naşterii (oraş, departament, ţara) / Lieu de naissance ( ville, département, pays ) /
Place of birth (city, department, country) …………………………………….…………………………
Adresa personală – domiciliul permanent / Adresse permanente / Address: (permanent address): ………………………………………………………………………………………….
cod poştal / code postal / Postcode: ………. Localitate/ville / City: ………………………
ţară/pays/ Country: …………………………………….
Telefon/Tél./ Telephone …………………… Fax /Télécopie/ Fax: ………………
E-mail/ Adresse électronique / E-mail: …………………….
Persoana de contact/Personne de contact / Contact person
Nume/nom/name
……………………………………………………………………………………
Adresa/Adresse/ Address: ……………………………………………………………………………………………………..
Telefon/Tél./ Telephone: ………………… Fax/Télécopie/ Fax: ………………….
Email/ Adresse électronique/E-mail::……………………….

Cunoştinţe lingvistice/ Langues étrangères/ Foreign languages:
lb. română/ le roumain/ Romanian □ nivel/niveau/ level.......................................................
lb. engleză/ l’anglais/ English □ nivel/niveau/ level ……………………………………………
alte limbi/ d’autres/ Others □ nivel/niveau/ level ………………………………………….

Limba de predare pe perioada studiilor în România este româna/
Langue d’enseignement pour la période d’études en Roumanie este le roumain/
The working language while studying in Romania is Romanian.

Solicit curs pregătitor de limbă română/Je sollicite l’inscription à un cours préparatoire de roumain/
I would like to attend Romanian classes before the beginning of my study in Romania:
Da/oui/ Yes □ nu/non/ No □




ETUDES EFFECTUÉES

Tipul de studii/
Type d’études/
Type of studies Instituţia
de învăţământ/
L’établissement/
Education Institution Perioada
de studii/
Période d’études/
Period Diploma obţinută
/
Diplômes/
Diplomas
Mediile obţinute,
pe ani de studiu/
Résultats obtenus par année d’étude/
Results, on academic years

Studii preuniversitare/

Etudes pré universitaires/
Under graduate studies











Studii universitare
(detaliat, pe ani academici/
Etudes universitaires
(à préciser pour chaque année)/
University studies
(please, detail on academic years)



Studii postuniversitare
(detaliat, pe ani academici)/
3-ème cycle
(à préciser pour chaque année)/
Post university studies
(please, detail on academic years)


Activitate profesională desfăşurată până în prezent (loc de muncă, funcţie, domeniu)/
Activité professionnelle effectuée jusqu’à présent (lieu de travail, fonction détenue, domaine d’activité)/ Professional experience until the present moment (jobs, position, field of work):
……………………………………………………………..............................................................
…………………………………………………………………………………………………….
……………………………………………………………..............................................................
……………………………………………………………..............................................................
……………………………………………………………..............................................................
Alte burse şi stagii de specializare efectuate/
Autres bourses et stages de spécialisation antérieurement effectués/
Other scholarships and specialization trainings:
……………………………………………………………………………………………………
……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………....
……………………………………………………………..............................................................
……………………………………………………………………………………………………
Motivaţia solicitării bursei de către candidat/
Précisez la motivation de la demande de bourse/
Applicant’s motivation:
………………………………………………………..……………………………………………
………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………………………………………………………………………
Descrierea proiectului de studiu (în cazul studiilor postuniversitare - masterat/ doctorat)/
Présentez le projet d’études (pour les études du 3ème cycle – master/doctorat)/
Project’s description (only for those students who apply for a Master/ PhD programme) :
……..……………………………………………………………………………………………………………………………………………………………………………………………….……………………………………………………………………………………………………….
……………………………………………………………..............................................................
……………………………………………………………..............................................................
……………………………………………………………..............................................................
Activitatea ştiinţifică a solicitantului (proiecte de cercetare, lucrări publicate, relevante pentru domeniu)/ Activité scientifique du candidat (projets de recherche, études publiées relevantes pour le domaine)/ Scientific activity (research projects, publications – relevant for this field of study): ……………………………………………………………………………………………………
……………………………………………………………..............................................................
……………………………………………………………..............................................................
……………………………………………………………………………………………………






III. Informaţii suplimentare/ Informations supplémentaires / Additional information:


Prin semnarea prezentului formular, solicitantul se obligă:
- Să ofere coordonate de contact corecte şi actualizate, necesare unei comunicări corespunzătoare;
- Să completeze, după caz, toate rubricile. Completarea incompletă sau incorectă determină statutul de „dosar incomplet” şi neparticiparea acestuia la concurs;
- În cazul în care candidatul nu menţionează două opţiuni pentru înscrierea la studii şi solicitarea sa nu poate fi onorată de universitatea specificată, Ministerul Educaţiei Naţionale, îşi rezervă dreptul de a propune candidatului o altă repartizare în acelaşi profil, conform disponibilităţilor instituţiilor de învăţământ superior din România. La primirea scrisorii de acceptare la studii cu noua repartiţie, candidatul este liber să accepte bursa sau să renunţe la ea, putându-se reorienta pentru continuarea studiilor în România pe cont propriu valutar;
- Dacă până la 10 iulie 2015, candidatul nu acceptă bursa sau, în cazul celor din ciclul secunda

Hasil (Inggris) 1:

ANNEX 1MINISTRY of Foreign Affairs-Directorate of public diplomacy, cultural and scientificMINISTRIES-Direction DES AFFAIRES ETRANGERES Diplomacy Culturelle et Scientifique Publique, MINISTRY OF FOREIGN AFFAIRS-Directorate Public Diplomacy, Cultural and Scientific Photo APPLICATION FOR SCHOLARSHIP FOR STUDIES IN INDIADEMANDE DE BOURSE D ' ETUDES EN ROUMANIEAPPLICATION FORM FOR SCHOLARSHIPS IN ROMANIA(to be completed in capital letters/A compléter en majuscules/ to be filled in capital letters) ACADEMIC YEAR/KATIE UNIVERSITAIRE/ACADEMIC YEAR 2015-2016 TYPE/TYPE OF SCHOLARSHIP BOURSE/SCHOLARSHIP TYPE:  undergraduate studies/études universitaires de licence/Bachelor's degree studies □ § specialization studies/stages de spécialisation Spécialisation courses/classes. Masters studies/études master/Master studies □  doctoral studies/doctoral/PhD thèse studies □OPTIONS for HIGHER EDUCATION INSTITUTION (2 options)/OPTIONS POUR L ' ETABLISSEMENT D ' ENSEIGNEMENT SUPÉRIEUR (2 options)/OPTIONS FOR UNIVERSITIES (2 options):City/la ville/city University/l ' université/university school/faculty/Specialization at the faculté/la spécialisation/specialization profiles THE IDENTITY OF THE CANDIDATE/L ' IDENTITE DU CANDIDATE/APPLICANT'S IDENTITY Name/Nom/Surname:........................................................... ………………………………………. Name before marriage/Nom de jeune fille/Maiden Name......................................................... … …………………………………………………………………………………………………………….. First Name/Prénom/Name:....................................................................................................Gender/Sex/Gender: M □ F □Marital/État civil Marital status: single/(a)//single room □ célibataire Married (2)/macca (s) □ Married/divorced (a)/divorcé (e)/□ divorcedNationality/Nationality/Nationalité........................................... Date of birth/Date de naissance/data of birth.................................................Place of birth (city, country, Department)/Lieu de naissance (ville, département, pays)/ Place of birth (city, country, department).........................................................................Personal-permanent residence address/Adresse/Address: permanent (permanent address):....................................................................................................... postal code/code postal/Postcode:.......... City/ville/City:........................... country/pays/Country:...........................................Phone/Tél./Telephone........................ Fax/Télécopie/Fax:.................. E-mail address/Adresse électronique/email:.........................Contact person/Personne ne contacts/Contact personName/nom/name ……………………………………………………………………………………Address/Adresse/Address:....................................................................................................................Phone/Tél./Telephone:..................... Fax/Télécopie/Fax:...................... Email/Adresse électronique/E-mail::............................Language/Langues étrangères knowledge/Foreign languages: lb./le roumain/Romanian Romanian □ level/niveau/level....................................................... lb. English/anglais/English d'Orange □ level/niveau/level................................................... other languages/d'autres/Others □ level/niveau/level.................................................Language of instruction during their studies in Romania is the Romanian/Langue d ' enseignement pour la période d ' études en Roumanie is le roumain/ The working language while studying in Romania is Romanian. I request the preparatory course Romanian language/Je l ' inscription sollicite à un cours préparatoire de roumain/ I would like to attend Romanian classes before the beginning of my study in Romania: Yes/oui/Yes □ No/non/No □ ETUDES EFFECTUÉESThe type of studies/Type d ' études/Type of studies Institutioneducation/L ' Etablissement autonome de/Education Institution During Thestudies/Période d ' études/Period Degree obtained/Diplômes/Diplomas De Averages obtained,on years of study/Résultats obtenus par année d ' étude/Results, on academic yearsUndergraduate studies/Etudes universitaires/préUnder graduate studies Undergraduate studies(detailed, scholarly/yearEtudes universitaires(à préciser pour chaque année)/University studies(please, detail on academic years) Postgraduate studies(detailed, academic years)/3-ème cycle(à préciser pour chaque année)/Post university studies (please, detail on academic years) Work done so far (job, function, domain)/ Activité professionnelle effectuée jusqu'la à présent (lieu de travail, détenue fonction, domaine d ' activité)/Professional experience until the present time (jobs, position, field of work): ……………………………………………………………..............................................................…………………………………………………………………………………………………….……………………………………………………………..............................................................……………………………………………………………..............................................................……………………………………………………………..............................................................Other scholarships and internships undertaken/trainingAutres bourses et stages de spécialisation effectués/antérieurement Other scholarships and specialization trainings:…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………....……………………………………………………………..............................................................……………………………………………………………………………………………………The motivation of the candidate/stock exchangePrécisez la motivation from demande de bourse/ Applicant's motivation: ………………………………………………………..…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………………………………………………………………Project description of study (in the case of postgraduate studies-master's/doctoral)/ Présentez le projet d ' études (pour les études du 3ème cycle-master/doctorate)/ Project's description (only for those students who apply for a Master/PhD programme):……..……………………………………………………………………………………………………………………………………………………………………………………………….……………………………………………………………………………………………………….……………………………………………………………..............................................................……………………………………………………………..............................................................……………………………………………………………..............................................................Activitatea ştiinţifică a solicitantului (proiecte de cercetare, lucrări publicate, relevante pentru domeniu)/ Activité scientifique du candidat (projets de recherche, études publiées relevantes pour le domaine)/ Scientific activity (research projects, publications – relevant for this field of study): …………………………………………………………………………………………………………………………………………………………………..............................................................……………………………………………………………..............................................................…………………………………………………………………………………………………… III. Informaţii suplimentare/ Informations supplémentaires / Additional information:Prin semnarea prezentului formular, solicitantul se obligă:- Să ofere coordonate de contact corecte şi actualizate, necesare unei comunicări corespunzătoare;- Să completeze, după caz, toate rubricile. Completarea incompletă sau incorectă determină statutul de „dosar incomplet” şi neparticiparea acestuia la concurs; - În cazul în care candidatul nu menţionează două opţiuni pentru înscrierea la studii şi solicitarea sa nu poate fi onorată de universitatea specificată, Ministerul Educaţiei Naţionale, îşi rezervă dreptul de a propune candidatului o altă repartizare în acelaşi profil, conform disponibilităţilor instituţiilor de învăţământ superior din România. La primirea scrisorii de acceptare la studii cu noua repartiţie, candidatul este liber să accepte bursa sau să renunţe la ea, putându-se reorienta pentru continuarea studiilor în România pe cont propriu valutar;- Dacă până la 10 iulie 2015, candidatul nu acceptă bursa sau, în cazul celor din ciclul secunda

Hasil (Inggris) 3:

ANNEX 1

THE MINISTRY OF FOREIGN AFFAIRS - Direction public diplomacy, Cultural and Scientific
ministries DES AFFAIRES ETRANGERES - Direction diplomacy Publique, Culturelle et Scientifique
MINISTRY OF FOREIGN AFFAIRS - directorates public diplomacy, Cultural and Scientific


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APPLICATION FOR scholarship FOR STUDY IN ROMANIA
DEMANDE OF bourse D'ETUDES EN ROUMANIE
APPLICATION FORM FOR scholarships IN ROMANIA
(to be completed in capital letters/compléter en majuscules/
to be filled in capital letters)


ACADEMIC YEAR/ ANNEE UNIVERSITAIRE / ACADEMIC YEAR

2015-2016



TYPE OF scholarship/ TYPE OF bourse/ scholarship TYPE:

 university of license /études universitaires of unit/ Bachelor's degree studies □