Vous êtes sur la page 1sur 1

UNIVERSIDADE FEDERAL DO CEAR

Via do professor CENTRO DE HUMANIDADES


SOLICITAO DE SEGUNDA CHAMADA

CASA DE CULTURA ___________________


Prezado aluno, anexe a este documento os comprovantes da justificativa dada por sua ausncia no local e horrio de
prova.
Informaes sobre o solicitante:
Nome:
Nmero de Matrcula:
Semestre: Turma:
Horrio: Professor:

Informaes sobre o exame:


1 Etapa
Leitura ( ) Compreenso Auditiva ( )
Gramtica ( ) Oral ( )
Redao ( )

2 Etapa
Leitura ( ) Compreenso Auditiva ( )
Gramtica ( ) Oral ( )
Redao ( )

Informes sobre a razo da ausncia:

Justificativa:
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________

Tipo de documento em anexo


Declarao ( ) Atestado mdico ( )
Outro ( )

Assinatura do aluno: _____________________________________________________________


Assinatura do professor _____________________________________________________________
Recebi em _______ / ______/ _______

Comprovante de Solicitao de segunda chamada Via do aluno


Provas: Compreenso auditiva ( ) Leitura ( ) Oral ( ) Gramtica ( ) Redao ( )
Datas: _____ / _____/ _____ _____ / _____/ _____
Horrios de: _____ s _______ de: _____ s _______
Assinatura do Professor:__________________________________