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£)aN XIN PHUC KHAO Krnh glii: Hoi dong thi Vi~n Goethe Ha Noi
Ten to; la: ................................................................................................................................................
Sinh ngay: ................................................................................................................................................
Ma 55 thl sinh: ........................................................................................................................................
s5 di~n thoi;li ....................................................... ; Email: ....................................................................
To; lam dO'n nay xin tr)nh bay mot vi~e nhU' sau:
Vao ngay .................................... toi co tham gia
ky thi .......................... eua Vi~n Goethe Ha NOi.
" Iam ' dO'n nayxm ' . p h'ue kh'ao b"al t h'/k, T01 muon 1 Y nangt h'1 ........................................................VI: A
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Rat mong Hoi dong thi xem xet Ii;li trU'Ctng hQ'p eua toi.
Xin chan thanh cam O'n!
Ha Noi, ngay .................... ..
NgU'Cti lam dO'n (Ky va ghi ro hQ ten)
Phon danh cho He; dong thi:
Lich hen phuc khao: .........................................................................................;............................... .