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PARTIDUL NATIONAL TARANESC CRESTIN DEMOCRAT

ORGANIZATIA JUDETEANA PNTCD BRASOV

PNTCD Piaţa George Enescu nr. 2, Tel/Fax: +40 268 478 265        

E-mail: [email protected]

CERERE DE INSCRIERE

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NUME SI PRENUME____________________________________________________________

DATA NASTERII______________PROFESIA__________________________________________

LOCUL DE MUNCA________________________FUNCTIA______________________________

DOMICILIUL___________________________________________________________________

TELEFON SERVICIU______________________TELEFON ACASA__________________________

B.I./C.I. SERIA________NR._______________ELIBERAT DE____________________________

C.N.P.__________________________COD LOCALITATE_______________________________

SOLICIT INSCRIEREA IN PARTIDUL NATIONAL TARANESC CRESTIN DEMOCRAT

DATA _______________ SEMNATURA______________________