Председателю СК «Рекорд»

                                                                         Н.А. Паламарчуку                                                              

                                                                        студента ______________________

                                                                                           (код группы)

                                                                                       _____________________________

                                                                                            (Ф.И.О.)

З А Я В Л Е Н И Е

         Прошу зачислить меня в секцию по ______________________________,

при СК «Рекорд».

Тренер-преподаватель _______________________________     _____________

                                                      (Ф.И.О.)                                                   (подпись)

Старший преподаватель _______________________________   _____________

                                                      (Ф.И.О.)                                                   (подпись)

__________________                                                                                         ______________

              (дата)                                                                                                             (подпись)