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<div align="center"><b>JELENTKEZÉSI  LAP</b></div>

<div align="center"><a href="mailto:szvitek.robert@hnm.hu">szvitek.robert@hnm.hu</a></div>

<div align="center"><a>mamutt@listserv.niif.hu</a></div>

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<div align="center">A Magyar Múzeumi Történész Társulat tanulmányútjára</div>

<div align="center"><b>2015. szeptember 23-26.</b></div>

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                        <div>Név:</div>
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                        <div>Gyulai Éva</div>
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                        <div>Munkahely neve:</div>
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                        <div>Herman Ottó Múzeum, Miskolc</div>
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                        <div>Munkahely címe:</div>
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                        <div>3529 Miskolc, Görgey 28.</div>
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                        <div>Értesítési cím (ha más mint a munkahely):</div>
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                        <div>3529 Miskolc, Dessewffy u. 20.</div>
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                        <div>Foglalkozás:</div>
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                        <div>tört-muzeológus, egy. docens</div>
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                        <div>Lakcím:</div>
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                        <div>3529 Miskolc, Dessewffy u. 20.</div>
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                        <div>Telefonszám:</div>
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                        <div>70/52-62-206</div>
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                        <div>E-mail cím</div>
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                        <div><a href="mailto:gyulai-eva@freemail.hu">gyulai-eva@freemail.hu</a></div>

                        <div><a href="mailto:gyulai.eva@uni-miskolc.hu">gyulai.eva@uni-miskolc.hu</a></div>
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                        <div>Személyi igazolvány- vagy útlevélszám:</div>
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                        <div>437767PA</div>
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                        <div>Közös szobában kérek elhelyezést a következő személlyel:</div>
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                        <div>Szeretnék egyedül aludni, a különbözetet kifizetem.</div>
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<div>Tagja-e a Magyar Múzeumi Történész Társulatnak? igen           </div>

<div>A 2015. évre a tagdíjamat befizettem: igen</div>

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<div>2015 július 25.</div>

<div align="right">Gyulai Éva</div>
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