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SECIGRA 2023
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APELLIDO PATERNO
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Your answer
APELLIDO MATERNO
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Your answer
NOMBRES
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Your answer
DNI
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FECHA DE NACIMIENTO
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MM
/
DD
/
YYYY
ESTADO CIVIL
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Soltero
Casado
SEXO
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Mujer
Varon
TELÉFONO
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Your answer
CÓDIGO POSTAL
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NÚMERO DE CELULAR
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CORREO ELECTRÓNICO
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DIRECCIÓN EXACTA
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DISTRITO
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PROVINCIA
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DEPARTAMENTO
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PRESENTA USTED ALGUNA DISCAPACIDAD
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Si
No
REGISTRO DE CONADIS
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Si
No
PROMEDIO PONDERADO
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AÑO DE POSTULACIÓN
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ESTUDIANTE O EGRESADO
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Estudiante
Egresado
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