ENTREVISTA

ESC SEC. GRL. “IGNACIO COMONFORT”

CLAVE: 10DES0034N
COL. ALVARO OBREGON, DGO.
FECHA:____________________
NOMBRE DEL ALUMNO (a):_______________________________________________________________
GRADO: ______________ SECCION: _____________
DOMICILIO:___________________________________________________________________________
QUIEN SOLICITA________________________________________________________________________
MOTIVO DE LA ENTREVISTA: _____________________________________________________________
NOM. DEL PADRE O TUTOR: ______________________________________________________________
EDAD: ________ OCUPACION: ____________________________________________________________
ESCOLARIDAD: _________________________________ TELEFONO: _____________________________

DESRROLLO DE LA ENTREVISTA:

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Conclusiones______________________________________________________________________________________
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FIRMA DEL PADRE O TUTOR: ______________________________________________________________

FIRMA DEL ALUMNO: ___________________________________________________________________