model_4 - formular COPSI
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ANEXA 1
PAGE
Model nr. 4 AFORMULAR DE ELIBERARE A ATESTATULUI DE LIBER PRACTICSubsemnatul posesor al CNP: am ridicat de la Comitetul director al Colegiului Psihologilor din Romnia atestatul de liber practic de la ........................................................................,n specialitatea: _____________ __________________________________,
treapta de specializare:.................................................................,
n regim de ______________________________________________________,
la data de ___________________________
DATE DE CONTACT (nr. de telefon i/sau adres de mail, care se vor afia pe site): Tel.: E-mail: SEMNTURA __________________________
SEMNTURA CELUI CE A PREDAT, _________________________________
