PLAN EDUCATIVO INDIVIDUALIZADO

(PEI)
AÑO ESCOLAR: _______________________ DURACIÓN: ___________________________
DATOS DE IDENTIFICACIÓN DEL ESTUDIANTE
Nombres y apellidos: ___________________________________ Fecha de nac. _____________________ Edad: ____________
Sexo: _____ Grado: _______ Cédula escolar: ____________________ Diagnóstico: _____________________________________
DATIS DEL REPRESENTANTE LEGAL DEL O LA ESTUDIANTE:
Nombres y apellidos: ________________________________________________________________________________________
C.I. V- ____________________ Telf. ______________________________ Parentesco:
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Dirección de habitación:
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PROPÓSITO GENERAL: _______________________________________________________________________________________
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SÍNTESIS DE LA EVALUACIÓN/ÁREAS
-PEDAGÓGICA (Académica)
Lectura y comprensión: ______________________________________________________________________________________
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Escritura:
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Matemáticas: ______________________________________________________________________________________________
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-PSICOMOTRICIDAD: ______________________________________________________________________________________
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-SENSO-PERCEPTIVA: ________________________________________________________________________________________
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-COGNITIVA-VERBAL: _______________________________________________________________________________________
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-SOCIO-EMOCIONAL: ________________________________________________________________________________________
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Potencialidades, Fortalezas, Necesidades e Intereses:
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Aportes de otros especialistas: ________________________________________________________________________________
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Factores de Riesgo Factores de Protección

IMPRESIÓN DIAGNÓSTICA:
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DOCENTE EVALUADOR: __________________________

DIRECTOR(A) ___________________________________ Sello Fecha: _____________________