UT Be Lau Te 12224 Sect 2. co pot 20396, ee, Roda A Sacer mars ce koopa CB secretariat @uteb ro, www iteb 0 wa @ rsa eck Somes cer Acord de preluorare a datelor cu caracter personal in cadrul Universitit Tehnice de Constructii Bucuresti ‘Subsemnatul/a (nume, prenume).... - » domiciliat/8in Nocaltate] nnn 7 -Judetul = 7 strads, -n088S0% al Cl seria... RUMTUI... seliberat de 1a data de a NP. Inv expim acordul cu prvi la utizarea gi pretcrarea datelor mee cu caracter personal de cdtre Universitatea ‘Tehnicd de Construct Bucuresti conform prevederir legi educatei nationale, a legior in vigoare precum gi ‘conform Regulamentului (UE) 679 / 2016 prlvind protectia persoanelor fizice In ceea ce priveste prelucrarea = ANUL(¥a)___ GRUPA (Grup, : NUMELE $I PRENUMELE (cuinitiala eta) (Surname and first name, with futher’ first sme in DATA SILOCUL NASTERI (Date and pace of binky VARSTA (ID series LADATADE ‘Tuts (i plicable) NR. FRATIIN INTRETINEREA PARINTILOR (prescolar, elevi, srudeng): (Nuanber of bigs under pret nancial support pre-school age cilren, polls, SudeNS) DOMICILIUL STABIL: (Permanent residence) LOC. (cityillage) sIRi (ive) _ ceria BL (okt fa SC. (mes). ET. (Qoor)___AP.@), ‘SECTOR (district) JUDET (county) TELEFON (horenrte), DOMICILIUL PE TIMPUL STUDILOR CAMIN/GAZDA: (Residence ding esd pod o— hosel rel) LOC. (tyvillage) ‘STR (set) ‘BL. tock offs SC. (extrance)_ ET, (floor) AP. (qt) ‘SECTOR (district) JUDET (county) _ ———_—__—_____ TELEFON CAMINNR (Hovelnon CAMERA NR (Room) ——— aSITUATIA $COLARA (dupa caz promovat, amanat, aménat exceptional, Prelung. medicalé a scolartai, "eluare studi, nse, enmatriculet sui univers efectute anterior tale / parle. ‘STATENENT OF ACADEMIC RECORD (crt tte cam, ped, Sfsvol esploaly ENG wae RS exteasion, "esuming suis transfered, r-maiclted previo sade ules tally paral epee) Declar prin prezenta cf am luat la cunoptingh si voi respecta Regulamentele privind desfigurares activitifi profesionale studenfilor, precum si cele privind comportarea studenfilor in spafiul de invifimAnt gi de cazare ale U.T.C.B, "herby decare that Ive ben informed on and shal comply withthe Regulation concerning student’ rofeiona stv and conduct within the enching and accommodation arets on the TUCES pevcies : ¢ Am lat lo cunogting& cd U.T.CB. pelucreazkdatele mele cu caracter persona in scopulinmatriculri i nlite. "hee enorme tht TUCER procene ny prea none prptof maton Cana Std ee hao rae nel eerlaad scare Dee ed See aera, Eda, Taare Sort Blnsr, conform Leg nr. 677240, Stdental bene de epalde aces e latenene oe poe sty ihe eed henge of ur being marclle, The dt cob ued the roe ‘Mah of nen, Youth ad Spt de baa soning Lav v.70. Te tenths ph aeeh eae e "lh oft blag alee anne deen edhe igh osc op fac DATA COMPLETARIL Sonne FILLIN DATE egNATURE_