GFPI-F-027 Formato Registro Socioeconomico APOYOS DE SOSTENIMIENTO

SERVICIO NACIONAL DE APRENDIZAJE SENA SISTEMA INTEGRADO DE GESTIÓN Y AUTOCONTROL PROCEDIMIENTO APOYOS DE SOSTENIMIENTO FORMATO DE REGISTRO DE CONDICIÓN SOCIECONÓMICA

EL FORMATO DEBE SER DILIGENCIADO POR EL APRENDIZ INTERESADO EN EL APOYO DE SOSTENIMIENTO

No#$%e&_____________________________________________ A'ei(o&___________________________________________ Do)*#en+o (e I(en+i(a( T"I",__ I",__ C"C", __ N- _____________________(e, ___________________ Se.o, F

M

E(a(, ____ E&+a(o Ci/i, _______________ Te1ono Te1ono Fio, ________________ ________________ Ce*a%, _________________________________ Di%e))i3n ___________________________________________________

4%ea %*%a, ____ 4%ea *%$ana, ____ E&+%a+o_____

Ba%% Ba%%io io5S 5Se) e)+o +o%_ %___ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ __M* M*ni ni)i )i'i 'io, o,__ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ _________________________________________________________ _________________ Co%%eo ee)+%3ni)o ________________________________________

Pe%&ona (e Con+a)+o ____________________________________Te1ono ____________________________________Te1ono (e )on+a)+o _________________________________ 7Tiene 8io&9 SI NO /i/en_______________________

C*an+o&, ____ Si +iene 8io&: (3n(e /i/en ; )on <*in

P%og%a#a (e Fo%#a)i3n, ___________________________________________________________________________________ N- (e Fi)8a, _______________ T%i#e&+%e, T%i#e&+%e, ____________ In&+%*)+o% ________________________________________________ In&+%*)+o% ________________________________________________ E&)oa%i(a(, Ba)8ie%, ________ T)ni)o, ________ Te)n3o Te)n3ogo, go, ________ O)*'a)i3n, ________________________________

@Ma%<*e )on *na  P%o'ia ___ A<*ia(a ___ Fa#iia% ___ A$e%g*e ___ O+%a___ C*>9 _______________________ _______________________ Ag*a, ___ L*6, ___ Te1ono, Te1ono, ___ Ga&, ___ In+e%ne+, ___

Si+*a)i3n La$o%a (e e1e (e Hoga%, Hoga%, T%a$aa(o% /in)*a(o, /in)*a(o, ____ T%a$aa(o% In(e'en(ien+e, In(e'en(ien+e, ____ De&e#'ea(o, ___ Pen&iona(o, ________

Se%/i)io #0(i)o )on e <*e )*en+a e a'%en(i6

EPS, ____ )*a, _________________________________________ Rgi#en Con+%i$*+i/o, _____

Rgi#en S*$&i(ia(o, _____

Ti'o Vin)*a)i3n, Co+i6an+e, ____ Bene1i)ia%io, ____

P*n+ae SISBN, ____________

M(i)o 'a%+i)*a%, ____

O+%o ____ C*>9 _________________________

7E& #oni+o%9 @E&+a en e '%og%a#a (e #oni+o%ia& (e >%ea (e $iene&+a% (e a'%en(i6 7E&+> 'a+%o)ina(o9 7Tiene o+%o $ene1i)io )on e Sena9 @ 7K* $ene1i)io9, 7E&+> in+e%e&a(o en '%o;e)+o '%o(*)+i/o9



7Tiene )on(i)iona#ien+o (e #a+%J)*a9 Página 1 de 4

GFPI-F-027.V.2


Fa#iia *ni'a%en+a @*n &oo 'a(%e a )a%go (e a 1a#iia o (e a'%en(i6 7Pe%+ene)e a '%og%a#a Re( ni(o&9 7Pe%+ene)e a '%og%a#a 3/ene& en A))i3n9 7E& /J)+i#a (e )on1i)+o a%#a(o9 7E& a'%en(i6 en &i+*a)i3n (e (i&)a'a)i(a(9 7E& (e&'a6a(o 'o% 1en3#eno& na+*%ae&9 7De$e (e&'a6a%&e 'o% #>& (e ?0# (e&(e &* *ga% (e /i/ien(a a Cen+%o (e Fo%#a)i3n9 7E& #a(%e o 'a(%e )a$e6a (e 1a#iia9 7E& J(e% /o)e%o (e &* '%og%a#a (e 1o%#a)i3n9 7Pe%+ene)e a Si&+e#a Na)iona (e Li(e%a6go o Vo*n+a%ia(o9 Vo*n+a%ia(o9

!" In1o%# In1o%#a% a% en a O1i)ina O1i)ina (e Bie Biene& ne&+a% +a% a A'%en A'%en(i6 (i6 ; a en)a%ga( en)a%ga(oo (e A'o;o& A'o;o& (e So&+en So&+eni#i i#ien+ en+oo in#e(i in#e(ia+a a+a#en #en+e +e e &ea a&igna(o a&igna(o )on+%a+o (e a'%en(i6a a'%en(i6ae: e: e#'eo: e#'eo: o )*a<*ie% )*a<*ie% o+%o $ene1i)io $ene1i)io (e Go$ie%no Go$ie%no o (e SENA @Moni+o%ia&: @Moni+o%ia&: A'o;o A'o;o (e &o&+eni#ien+o FIC: In+e%na(o: en+%e o+%o& 2" Man+ene% Man+ene% $*en $*en ni/e ni/e a)a(# a)a(#i)o: i)o: a)+i a)+i+*(in +*(ina a ; (i&)i'in (i&)i'ina%io" a%io" ?" C*#'i% C*#'i% )on e 'e%1i (e a*#no a*#no SENA @LJ(e% @LJ(e%:: )%ea+i/o: )%ea+i/o: i$%e i$%e 'en&a(o%: 'en&a(o%: &oi(a%io &oi(a%io:: e#'%en(e(o%" e#'%en(e(o%" " C*#'i% C*#'i% )on )on a& a& a&e&o a&e&o%Ja& %Ja& (e >%ea (e E#'%en E#'%en(i#i (i#ien+o" en+o" " C*#'i C*#'i%% )on e n#e% n#e%oo (e 8o%a& 8o%a& )o#o )o#o ge&+o% ge&+o% #oni+o #oni+o%"%"

!" Fo+o)o Fo+o)o'ia 'ia (o)* (o)*#en #en+o +o i(en+ i(en+i(a i(a(( /igen+ /igen+e" e" 2" Fo+o)o'ia Fo+o)o'ia (e *n %e)i$o %e)i$o (e Se%/i)i Se%/i)ioo P$i)o: P$i)o: (e #>.i#o #>.i#o +%e& +%e& @? #e&e& #e&e& (e e.'e(i) e.'e(i)i3n" i3n" ?" Fo+o)o'ia Fo+o)o'ia (e Si&$n Si&$n o EPS, Ce%+i1i) Ce%+i1i)a)i3n a)i3n (e &* EPS @En+i(a @En+i(a(( P%o#o+o%a P%o#o+o%a (e Sa*( o IPS @In&+i+ @In&+i+*)i3n *)i3n P%e&+a(o P%e&+a(o%a %a (e Sa*( (on(e )on&+e <*e e& $ene1i)ia%io (e Rgi#en S*$&i(ia(o en Sa*( o $ene1i)ia%io (e Rgi#en Con+%i$*+i/o: (e #>.i#o *n @! #e& (e e.'e(i)i3n" " En )a&o (e &e% a'%en(i6 a'%en(i6 Re( Re( ni(o& o Vi)+i# Vi)+i#aa (e Con1i)+o Con1i)+o A%#a(o A%#a(o (e$en (e$en en+%ega% en+%ega% &o'o%+e (e e&+a e&+a &i+*a)i3n &i+*a)i3n"" " Y +o(o a<*e a<*e (o)*#en+o (o)*#en+o <*e &o'o%+e &o'o%+e ag*no ag*no (e o& )%i+e%io& )%i+e%io& (e '%io%i6a '%io%i6a)i3n: )i3n: e&+a$e e&+a$e)i(o )i(o en e&+a e&+a g*Ja"

No+a, Pa%a a a&igna)i3n (e A'o;o (e So&+eni#ien+o: e a'%en(i6 (e$e en+%ega% )o'ia (e e&+e 1o%#a+o a LJ(e% (e Biene&+a% ; O%igina a a 'e%&ona en)a%ga(a (e A'o;o& (e So&+eni#ien+o& en e Cen+%o (e 1o%#a)i3n: en a& 1e)8a& '%e/i&+a& en e )%onog%a#a (e a )on/o)a+o%ia" La no en+%ega (e o& (o)*#en+o& i#'e(i%> <*e )on+ine )on e '%o)e&o"

7E a'%en(i6 8a &*&)%i+o o +iene &*&)%i+o )on+%a+o (e a'%en(i6ae SENA9 SI NO Fe)8a, OBSERVACIONES, ________________ ________________________________ ___________________ ___ ________________ ________________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ _________________ ____________ ___ ________________ ________________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ _________________ ____________ ___ No#$%e__________________________________ Fi%#a %e&'on&a$e____________________________________

7E a'%en(i6 )*#'e )on o& )%i+e%io& (e $*en %en(i#ien+o a)a(#i)o 'a%a %e)i$i% e a'o;o (e &o&+eni#ien+o9 SI NO OBSER OBSERVVAC ACION IONES_ ES____ ______ _____ _____ ______ _____ _____ ______ _____ _____ ______ _____ _____ ______ _____ _____ ______ ______ _____ _____ _____ ________________ ________________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ _________________ ____________ ___ ________________ ________________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ _________________ ____________ ___ Página 2 de 4

GFPI-F-027.V.2


No#$%e__________________________________ Fi%#a LJ(e% %e&'on&a$e_______________________________

En+%e/i&+a, En+%e/i&+a, SI

NO

Fe)8a, Fe)8a, ___ _______ ________ _______ ___ Re&*+a( Re&*+a(oo (e a En+%e/i&+a En+%e/i&+a,, ________ ____________ ________ ________ ________ ______

________________ ________________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ _________________ ____________ ___ ________________ ________________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ _________________ ____________ ___ ________________ ________________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ _________________ ____________ ___ ________________ ________________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ _________________ ____________ ___ ________________ ________________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ _________________ ____________ ___ Se %eai63 Vi&i+a Do#i)iia%ia Do#i)ii a%ia SI NO Fe)8a, _______________ Re&*+a(o (e a Vi&i+a, __________________ ________________ ________________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ _________________ ____________ ___ ________________ ________________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ _________________ ____________ ___ ________________ ________________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ _________________ ____________ ___ OBSERVACIONES____________________________________________________________________________

No#$%e__________________________________ Fi%#a %e&'on&a$e____________________________________

7E 7E a'%e a'%en( n(i6 i6 e&+> e&+> en e+a' e+a'aa '%o( '%o(*) *)+i+i/a /a99 SI NO Si e&+> en e+a'a '%o(*)+i/a: 7%eai63 e %egi&+%o ; +iene a/ao &* i(ea (e P%o;e)+o P%o(*)+i/o en a ni(a( (e E#'% E# '%en en(i (i#i #ien en+o +o99 SI NO Fe)8 Fe)8aa OBSERVACIONES____________________________________________________________________________ ________________ ________________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ _________________ ____________ ___ ________________ ________________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ _________________ ____________ ___ No#$%e__________________________________ Fi%#a LJ(e% %e&'on&a$e_______________________________

Ha)e en+%ega en+%ega (e o& &o'o%+e& &o'o%+e& )o#'e+o )o#'e+o&& SI

NO

Se %eai63 %eai63 En+%e/i&+a, En+%e/i&+a, SI

NO

Fe)8a Fe)8a

Re&*+a(o (e a En+%e/i&+a, ______________________________________________________________________ ________________ ________________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ _________________ ____________ ___ ________________ ________________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ _________________ ____________ ___ P*n+ae (e Cai1i)a)i3n Cai1i)a)i3n ; P%io%i6a)i3n P%io%i6a)i3n _______ _______ Fe)8a (e P%io%i6a)i3n P%io%i6a)i3n A)+a (e De&e#'a+e SI NO E a'%en(i6 &e%> a(*(i)a(o )on a'o;o, SI NO Re&o*)i3n No" _____(e ______ O$&e%/a)ione& _______________________________________________________________________________ ________________ ________________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ _________________ ____________ ___ ________________ ________________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ _________________ ____________ ___ ________________ ________________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________ _________________ ____________ ___ Página 3 de 4

GFPI-F-027.V.2


No#$%e__________________________________ Fi%#a %e&'on&a$e____________________________________

Página 4 de 4

GFPI-F-027.V.2

GFPI-F-027 Formato Registro Socioeconomico APOYOS DE SOSTENIMIENTO

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