ICJ – INSTITUTO DE CIÊNCIAS JURÍDICAS

CURSO DE DIREITO
Port. Rec. nº. 550 SETOR DE ATIVIDADES COMPLEMENTARES
D.O.U. 09/11/88
Campus S.J. Rio Preto II

FORMULÁRIO PARA ACOMPANHAMENTO DE ATIVIDADE

Campus: _____________ Mês:_____________________________ Ano: _____________

1. Aluno(a) : __________________________________________________________________________
2. Ano / Turma / Período: ___________________________________________ RA: ______________
3. Professor(a) Orientador(a): __________________________________________________________
4. Disciplina: __________________________________________________________________________
5. Tipo de Atividade / Local: ____________________________________________________________
6. Data da Atividade: ___________________________________ Total de Horas: ________________
7. Chancela do Responsável pelo Local do Evento:
Data: ______ / ______ / ______ Visto/Carimbo: __________________________________
8. Relatório da Atividade:
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Data: ______________________ Assinatura do Aluno: ___________________________________

9. Controle do(a) Professor(a) Orientador(a):

Horas/Atividade: _________ h Visto: _____________________ Data: ______ / ______ / ______

Para Controle do SAC

Data: ______________________ Protocolo: _______________________________________