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Cursinho Central ENEM SEED - UEAP
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Nome:
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Turma que pretende concorrer a vaga:
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Data de Nascimento:
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RG:
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CPF:
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Nacionalidade:
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Naturalidade:
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Endereço:
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Sexo:
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Idade:
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Estado Civil:
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Raça/Cor/Etnia:
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Se enquadra em alguma modalidade de cota?
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Cursa (ou) o ensino fundamental em:
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Se em Instituição Privada, com bolsa?
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Cursa (ou) o ensino médio em:
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Se em Instituição Privada, com bolsa?
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Você veio de outro Estado?
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Se sim, qual?
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Você reside com:
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Em qual bairro você mora?
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Meio de transporte:
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Qual a condição do imóvel que você mora?
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Qual a estrutura do imóvel?
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Número de cômodos:
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Localização do imóvel:
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A Rua é Pavimentada?
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Tem água encanada e tratada?
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Tem coleta de lixo?
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Quantas pessoas moram na sua casa (incluindo você)?
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Você tem filhos:
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Se sim, quantos?
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Quantos tem menos de 12 anos?
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Quantos tem entre 12 e 18 anos?
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Renda per capta da família:
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