Warsaw, ........................
(DATE)
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(NAME & SURNAME)
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(STUDENT ID NUMBER)
Piotr Maszczyk, PhD
Vice Dean of Undergraduate Studies
I hereby declare that I would like to conduct the following adjustments to my course
declaration in the Virtual Dean’s Office:
Course code
(10 digits)
Course title
Group
number
DELETE*
ADD*
Lecturer’s signature
Specify the reason:
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(STUDENT’S SIGNATURE)
* Tick if applicable