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  • Anexo #1 Ficha de Inscripción SRM 2015

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    Anexo Nº 1 Ficha de Inscripción SRM 2015

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    © All Rights Reserved
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    0 views2 pages

    Anexo #1 Ficha de Inscripción SRM 2015

    Uploaded by

    JC Catu
    word

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 2

    Anexo N 1

    FICHA DE INSCRIPCIN
    Secundaria Rural Mejorada
    Nro de DNI
    Apellido Paterno
    Apellido Materno
    Nombres
    Correo Electrnico
    Telfono de Referencia
    Direccin
    Distrito/Provincia/Depar
    tamento
    Profesin
    Especialidad
    La informacin proporcionada constituye DECLARACIN JURADA
    Marcar con una aspa (X) la(s) regin(es) de su preferencia
    REGIONES
    AMAZONAS
    ANCASH
    APURIMAC
    AREQUIPA
    AYACUCHO
    CAJAMARCA
    CALLAO
    CUSCO
    HUANCAVELICA
    HUANUCO
    ICA
    JUNIN
    LA LIBERTAD
    LAMBAYEQUE
    LIMA METROPOLITANA
    LIMA PROVINCIAS
    LORETO
    MADRE DE DIOS
    MOQUEGUA
    PASCO
    PIURA

    PUNO
    SAN MARTIN
    TACNA
    TUMBES
    UCAYALI

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