INSTITUCIN EDUCATIVA CRISTIANA

INTERNACIONAL ELIM

FICHA DE ENTREVISTA AL PADRE DE FAMILIA

Fecha: ___/___/_____
DATOS DE FILIACIN:

Nombres y Apellidos: __________________________________________ Edad: _____ Parentesco: __________

Nombres y Apellidos del menor: ______________________________________________________________
Grado y Seccin: __________________ Nivel: ___________________

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MOTIVO DE CONSULTA
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ANTECEDENTES PERSONALES Y FAMILIARES

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ACUERDOS Y RECOMENDACIONES:
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Formando Alumnos con Futuro

INSTITUCIN EDUCATIVA CRISTIANA
INTERNACIONAL ELIM

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FIRMA DEL PADRE DE FAMILIA
DNI _______________

Formando Alumnos con Futuro