Post on 04-Feb-2018
7/21/2019 Ficha de Inscripcion Estudiantil
1/1
CompaaDe Transporte Jvenes Del Futuro
Transjodefu S. A.
FICHA DE INSCRIPCION ESTUDIANTILUNIDAD EDUCATIVA CARDENAL SPELLMAN
AO LECTIVO 2014 - 2015
DATOS DE FILIACIN ESTUDIANTE:
NOMBRES com!"#o$: %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%APELLIDOS com!"#o$: %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%EDAD: %%%%%%%%% &RADO: %%%%%% PARALELO: %%%%%%
DIRECCION DOMICILO:
SECTOR: %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%BARRIO: %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%CIUDADELA: %%%%%%%%%%%%%%%%%%%%%%%%%%%%%REFERENCIA: %%%%%%%%%%%%%%%%%%%%%%%%%%%%%CALLES: PRINCIPAL: %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%CASA N':%%%%%%%%% SECUNDARIA: %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
NOMBRE CON(UNTO HABITACIONAL: %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% BLO)UE N': %%%%%%%%%DEPARTAMENTO N': %%%%%%% CASA N': %%%%%%%%%%%%%%%%%
REPRESENTANTE ESTUDIANTE:
Nom*+" , N' " RUC ./O C! " I"3# + "m#+ 6c#+$7%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
NOMBRES com!"#o$: %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%APELLIDOS com!"#o$: %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%N' CELULAR: %%%%%%%%%%%%%%N' CELULAR: %%%%%%%%%%%%%%%%N' CELULAR: %%%%%%%%%%%%%%%TEL8FONO OFICINA: %%%%%%%%%%%%%%% TEL8FONO RESIDENCIA: %%%%%%%%%%%%%%%%%%%D+"cc93 R"$"3c:%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
N' DE RUTA UNIDAD: %%%%%%%% ENTRADA . SALIDA: %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%SERVICIO DE TRANSPORTE )UE UTILIA:
ENTRADA: %%%%%% RUTA N'%%%%% SALIDA: %%%%%% RUTA N': %%%%%%
)UE MODALIDAD DE TRANSPORTE SOLICITA:
PERSONALIADO PUERTA A PUERTA: SI: %%%% NO: %%%%&ENERALIADO BUS: SI: %%%% NO: %%%%COSTOS: S"+;co T+3$o+#" &"3"+!5000 9!+"$ S"+;co T+3$o+#" P"+#/P"+#====>?500 9!+"$
Se solicita adjuntar croquis de ubicacin domicilio
Firma Representante
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