SECRETARIA DE EDUCACION Y CULTURA.

DIRECCIN DE EDUCACIN ESPECIAL.

CENTRO DE ATENCIN MLTIPLE # 4 3.

Club Rotario #10. Nogales, Sonora. Tel; 31-5-81-23.

ENTREVISTA AL ALUMNO
I.- FICHA DE IDENTIFICACION:
NOMBRE: ____________________________________ FECHA DE A _______________
FECHA DE NACIMIENTO: _____________________________ EDAD: ______________
NOMBRE DE LA MAMA: ___________________________________________________
NOMBRE DEL PAPA: ______________________________________________________
DIRECCION: ___________________________________ TELEFONO: _______________
OCUPACION DE LOS PADRES: ______________________________________________
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II.- ACTITUD HACIA EL C. A. M.

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III.- EXPERIENCIA DE TRABAJO:
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IV.- ACTIVIDADES QUE LE AGRADAN:

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V.- IDENTIFICACION CON LOS MIEMBROS DE LA FAMILIA:
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VI.- IDENTIFICACION CON OTRAS PERSONAS:
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VII.- EXPECTATIVA PATERNAL Y ACTITUD ANTE ELLA:
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VIII.- EXPECTATIVA PERSONAL:
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IX.- OBSERVACIONES:
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