FIA DE EVALUARE COMPLEX

Trimis de: Serviciul de Evaluare si Orientare Scolara/Profesionala, Sibiu

Motivul trimiterii: Evaluare dosar de orientare scolara/profesionala

ANCHETA SOCIAL
Date generale i familiale:
Nume: ____________________________ Prenume: ___________________________________
Date naterii: _______________ Locul naterii: ________________
Domiciliul: ___________________________________________________________________________________
Tatl (nume, prenume, profesie, loc de munc): _______________________________________________________
Mama (nume, prenume, profesie, loc de munc): ______________________________________________________
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Condiii de locuit: ______________________________________________________________________________

Relaiile ntre prini: ___________________________________________________________________________
Relaiile ntre prini i copii: _____________________________________________________________________
Atitudinea prinilor fa de educaia copilului: _______________________________________________________
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Surse de venit: _________________________________________________________________________________

Influene ambientale: ____________________________________________________________________________
_____________________________________________________________________________________________

Meniuni speciale: ______________________________________________________________________________

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ntocmit de: ____________________________

Data: ___________________

Semntura: ______________________