MODELO DE ENTREVISTA A REPRESENTANTES

 

República Bolivariana de Venezuela

U.E. Colegio Santa Mariana de Jesús

Inscrito en el  MPPE en el año 1950-1951

Cod. Plantel: S0399D2015 Cod. AVEC: 230028 RIF: J-31070540-2

Convenio MPPE-AVEC

SERVICIO DE ORIENTACION EDUCATIVA

Entrevista a Representantes

Nombres: ___________________________________Apellidos:_________________________ Grado/Año:__________ Edad: ______Sexo ____ Fecha de la Entrevista___________________ Dirección : ____________________________________________________________________ Teléfonos:________________________email_______________________Representante Legal ________________________________________Padre(  ) Madre(  ) otro(  )________________ Personas con quien vive______________________________________________ Docente Guia o Maestra(o)__________________________Remitido por _____________________________

MOTIVO DE LA ENTREVISTA: _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

EXPOSICION DEL REPRESENTANTE : _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

ACUERDOS: _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

FIRMA DEL REPRESENTANTE                             DOCENTE                                            ORIENTADOR