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Administracin Federal de Servicios Educativos en el Distrito Federal

Direccin General de Innovacin y Fortalecimiento Acadmico


Direccin de Programas de Innovacin Educativa
Coordinacin de Ingls en el Distrito Federal

Escuela:
Profesor (a):
Prctica Social:
Competencia Especfica:

Escuela Sec. Lic. Benito Jurez.


Mara Fernanda Anaya Corrales.
Understand and convey information about goods and services.

CCT:
Unidad:
Ambiente:

Provide and be provided with information about performing a community


service.

Producto Final:

1
Familiar and
community
Acting-out of a
dialogue.

Mes:
Grado:
Grupo (s):

September - Octuber
1st
A,B,C,D

Tres sesiones de 50 min ala


semana. Secundaria

Learning environment 1
Identifies topic, purpose and intended audience.
Rbrica

Proyectos

Predicts the general meaning from words and expressions similar to those of the
Lista de cotejo

Esquemas

mother tongue.
Anecdotario

Registro de actitudes

Aprendizajes
Instrumento (s)
Distinguishes expressions in oral exchanges.
Observacin directa
Portafolio

Esperados:
de evaluacin:
Recognizes the composition of expressions in oral exchanges.
Producciones escritas
Pruebas escritas u orales
Produces expressions to provide information.
Adjusts volume and speed when constructing oral texts.
Acting-out a dialogue
Choose a classmate to act-out a dialogue about providing services.
Choose the community service about which information is to be exchanged.
Etapa (s) del
Decide roles and turns of participation.
producto:
Write sentences to give and receive information.
Check that sentences are understood when spoken and listened to.
Practice sentences.
Perform the dialogue.
Articulacin de Contenidos
weeks
Actividades
Hacer con el lenguaje
Listen and check a dialogue about the
performance of community service.
Verb to be
Recognize topic and purpose.
Discriminate environment sounds and
1
background noise.
Verbs table, whiteboard activities, formulates sentences with verb to be in the note book, book pages 8 and 9 and
Identify form of communication.
worksheets.
Distinguish between intonation and attitude.
Establish the relationship between participants.
Understand the general meaning and main
ideas.
Activate previous knowledge.
Find out the meaning of words.
Identify words used to link ideas.
Find key words.
Determine sequence of statements (for example:
description, instruction, etc.).
Exchange information about the performance
of community Service.
Use an appropriate speech register based on the
addressee.
Write sentences.
Read sentences to practice pronunciation.
Formulate and answer questions to give and
request information.
Start a dialogue with the help of written
guidelines.

Places.
Images about different places in the city, reader book page 7-16 lets go to boulder questions in the
notebook about it, worksheets in the note book, book allready pages 10-13.

Administracin Federal de Servicios Educativos en el Distrito Federal


Direccin General de Innovacin y Fortalecimiento Acadmico
Direccin de Programas de Innovacin Educativa
Coordinacin de Ingls en el Distrito Federal

Adjust volume and speed.


Saber acerca del lenguaje

WH questions and sings of places.


Topic, purpose and intended audience.
Context clues: environment sounds, background
noise, relationship between participants, attitudes,
etc.
Form of communication: on-site, distance.
Structure of dialogue, opening, body, closure.
Speech register.
Repertoire of words necessary for this social
practice of the language.
Composition of expressions.
Similarities and differences between the mother
tongue and English language.
Acoustic features: tone, intonation and
pronunciation. Sentence types.
Connectors (e.g., if, then, and, because).
Verbs: modals.

Teachers is going to explain the differences questions with wh, In the notebook thir going to formulate they own
questions and ask t other classmate, show the different signs they can find in the community places, have the
vocabulary in their notebooks, book all ready pages 14-17.
3

Modals verbs, product 1.

Ser con el lenguaje


4
Explain modals verbs, activities in the notebook, participations in the class and front of the class (extra points).
Participate appropriately during oral exchanges.
Book all ready pages 18-21. Present the product 1 (Acting-out of a dialogue) in teams. And present bimestrial
Foster confidence within interpersonal
test.
relationships.
Materiales
Book, Notebook,Marks, images, wallcharts, candies and worksheets.
educativos
complementarios:
Observaciones:

Nombre del
Director

Firm
a

Fecha

Sello

Administracin Federal de Servicios Educativos en el Distrito Federal


Direccin General de Innovacin y Fortalecimiento Acadmico
Direccin de Programas de Innovacin Educativa
Coordinacin de Ingls en el Distrito Federal

Escuela:
Profesor (a):
Prctica Social:
Competencia Especfica:

Escuela Sec. Lic. Benito juarez.


Mara Fernanda Anaya Corrales.
Read and understand different types of literary texts distinctive of Englishspeaking countries.

CCT:
Unidad:
Ambiente:

1
Literary and ludic

Read classic tales and write a short story based on them.

Producto Final:

Broadsheet book

Mes:
Grado:
Grupo (s):

September - Octuber
1st
A,B,C,D

Tres sesiones de 50 min ala


semana. Secundaria

Learning environment 2
Uses known comprehension strategies.
Rbrica

Proyectos

Recognizes the general meaning from some details.


Lista de cotejo

Esquemas

Aprendizajes
Formulates and answers questions in order to locate specific information.
Instrumento (s) Anecdotario

Registro de actitudes

Esperados:
Expresses personal reactions to literary texts, using known oral expressions.
de evaluacin:
Observacin directa
Portafolio

Retells events using images.


Producciones escritas
Pruebas escritas u orales
Organizes sentences into a sequence of actions.
Big book
Select and read a classic story.
Determine which the key events are.
Etapa (s) del
Write and arrange the sentences based on key events.
producto:
Check that the sentences comply with grammar, spelling and punctuation conventions.
Put together and illustrate the big book. Rehearse the oral reading out loud of the text and practice pronunciation.
Read the book out loud and donate it to students from basic education lower grades.
Articulacin de Contenidos
Semana
Actividades
Hacer con el lenguaje
Select and check classic tales.
Recognize graphic and text arrangement.
Parts of a story
Identify the author(s).
Activate previous knowledge.
1
Determine topic, purpose and intended
Show to the students a fairytale and explain the parts of a story, now about what fairytales the students knows,
audience.
work in the notebook, reader book page 20-29, answers the activities and work in the notebook. All ready book
Read and understand the general meaning and
page 22-24.
main ideas of a classic tale.
Predict contents based on graphic and text
components.
Use different comprehension strategies (e.g.,
skimming, scanning, adjusting speed and rhythm).
Detect sounds represented by different letters or
their combination.
Establish forms that express continuous and
past actions.
Identify key events.
Recognize the general meaning.
Determine number and order of key events.
Speak about and rewrite key events of a
classic tale.
Speak about personal reactions and opinions of
an event.
Retell events from illustrations.
Rewrite sentences of key events.

Past (simple, continuous, interrupted past), verbs (past and progressive )


Explain the past and the different structures, activities in the notebook sentences in past, conjugate verbs in past,
participate in teams, all ready book page 25-29.

Administracin Federal de Servicios Educativos en el Distrito Federal


Direccin General de Innovacin y Fortalecimiento Acadmico
Direccin de Programas de Innovacin Educativa
Coordinacin de Ingls en el Distrito Federal

Complete sentences that express continuous


and past actions.
Rewrite key events.
Saber acerca del lenguaje

Adverbs of the time.

Topic, purpose and intended audience.


Graphic components.
Textual components. Narrative elements.
Repertoire of words necessary for this social
practice of the language.
Verb tenses: past.
Verb forms: progressive.
Adverbs of time and pronouns.
Non-frequent or absent letter groups found in
mother tongue (e.g., ee, gh).
Differences between British and American
variants (e.g., -our/-or, -re/-er).

The students are going to learn the different adverbs of the time and participate in the whiteboard for extra points,
activities in pairs, worksheets in the notebook, and answer the all ready book page 30-33

Product 2 (broadsheet book)


The students are going to pick a fairytale story and going to work in teams, the students are going to work in the
project, a present in front of the class room.
Ser con el lenguaje
4
Acknowledge reading as a recreational activity.
Understand and appropriately contribute in
discussions.
Foster respect towards others opinions
Materiales
Book, Notebook, Marks, images, wallcharts and worksheets.
educativos
complementarios:
Observaciones:

Nombre del
Director

Firm
a

Fecha

Sello

Administracin Federal de Servicios Educativos en el Distrito Federal


Direccin General de Innovacin y Fortalecimiento Acadmico
Direccin de Programas de Innovacin Educativa
Coordinacin de Ingls en el Distrito Federal

Escuela:
Profesor (a):
Prctica Social:
Competencia Especfica:

Escuela Sec. Lic. Benito Jurez.


Mara Fernanda Anaya Corrales.
Understand and convey information about good and services.

CCT:
Unidad:
Ambiente:

Offer and understand suggestions in order to purchase or sell products.

Producto Final:

1
Familiar and
community
Catalogue of goods

Mes:
Grado:
Grupo (s):

September - Octuber
2nd
A,B,C,D

Tres sesiones de 50 min ala


semana. Secundaria

Learning environment 1
Anticipates the general meaning and main ideas by listening to familiar
Rbrica

Proyectos

expressions.
Lista de cotejo

Esquemas

Aprendizajes
Identifies main ideas in oral exchanges.
Instrumento (s) Anecdotario

Registro de actitudes

Esperados:
Searches for confirmation in an oral exchange.
de evaluacin:
Observacin directa
Portafolio

Produces expressions to argue or object.


Producciones escritas
Pruebas escritas u orales
Adjusts tone, rhythm, and intonation in producing oral texts.
Goods catalogue
Select the goods to be included in the catalogue.
Design the catalogue format and illustrate its products.
Etapa (s) del
Write suggestions about the products included in the catalogue.
producto:
Check that the suggestions comply with grammar, spelling and punctuation conventions.
Practice the enunciation of suggestions, using the catalogue as a guide.
Present the catalogue to a previously selected audience.
Articulacin de Contenidos
semana
Actividades
Hacer con el lenguaje
Sell products (clothes, accessories, toys) and comparative sentences.
Listen to and check suggestions to buy or sell
a product (e.g., clothing, toys, appliances,
etc.).
Show flash cards with clothes and products, vocabulary of sell goods, dialogues from a costumer and seller and
1
Identify topic and purpose.
practices, activities in the notebook, cars with images of the clothes and goods, compare the prices of the goods,
Identify sounds that reveal the location where a
all ready book pages 8-11
dialogue takes place.
Identify the relationship between speakers.
2
Detect rhythm, tone, speed, and intonation.
Adjectives, adverbs ( comparatives and superlatives)
Understand the general meaning and main
ideas.
Show a list of adjectives and adverbs and they different forms, with the vocabulary in the notebook, activities in
Activate previous knowledge to anticipate the
the notebook, reader pages 7-17, all ready book pages 12-16.
general meaning and main ideas.
Identify terms that are similar to those in the
mother tongue.
Identify ways to express suggestions.
Detect expressions to argue or object.
Identify strategies to emphasize meaning (e.g.,
rephrasing, and adjusting volume/speed).
Formulate questions and answers to understand
a dialogue.
Determine sequence of enunciation.
Express suggestions in a dialogue, based on a
script.
Produce expressions to argue or object to the
purchase or selling of products.

Administracin Federal de Servicios Educativos en el Distrito Federal


Direccin General de Innovacin y Fortalecimiento Acadmico
Direccin de Programas de Innovacin Educativa
Coordinacin de Ingls en el Distrito Federal

Select and adjust verbal and non-verbal


behaviors for a specific audience.
Include relevant details and interesting
information
Construct expressions to offer alternatives to
Saber acerca del lenguaje

Modal verbs
Topic, purpose, and intended audience.
Contextual clues.
Structure of dialogues.
Repertoire of words necessary for this social
practice of the language.
Verbs: modals.
Verb forms: subjunctive.
Acoustic features.
Connectors.
Adjectives: qualifying, comparative, and
compound.
Comparative structures (e.g., asas; like;
more slowly, less quickly; the least, the
quickest).
Adverbs: of degree (e.g., very, too, and rather).
Sentence types
Ser con el lenguaje

The students are going to read sentences with modal verbs and identify them, then make their own sentences I
the notebook, all ready book 17-19

Product 1 (catalogue of goods)


4

Students are going to work in team and make a catalogue of goods with trimmings and the prices of the goods.
All ready book pages 20-21

Show assertiveness when making decisions.


Foster courtesy in interpersonal relationships
Materiales
educativos
complementarios:

Book, Notebook, Marks, images, flashcards, magazines, paper, glue, wallcharts and worksheets.

Observaciones:

Nombre del
Director

Firm
a

Fecha

Sello

Administracin Federal de Servicios Educativos en el Distrito Federal


Direccin General de Innovacin y Fortalecimiento Acadmico
Direccin de Programas de Innovacin Educativa
Coordinacin de Ingls en el Distrito Federal

Escuela:
Profesor (a):
Prctica Social:
Competencia Especfica:

Escuela Sec. Lic. Benito Jurez.


Mara Fernanda Anaya Corrales.
Read and understand different types of literary texts distinctive of Englishspeaking countries.

CCT:
Unidad:
Ambiente:

1
Literary and ludic

Read fantasy literature and describe characters.

Producto Final:

Comic book

Mes:
Grado:
Grupo (s):

September - Octuber
2nd
A,B,C,D

Tres sesiones de 50 min ala


semana. Secundaria

Learning environment 2
Uses strategies to support the understanding of narratives.
Rbrica

Proyectos

Anticipates the general meaning and main ideas from details.


Lista de cotejo

Esquemas

Aprendizajes
Instrumento (s)
Distinguishes explicit from implicit information.
Anecdotario

Registro de actitudes

Esperados:
de evaluacin:
Formulates and answers questions to distinguish and verify specific information.
Observacin directa
Portafolio

Describes characteristics and abilities.


Producciones escritas
Pruebas escritas u orales
Comic strip
Select and read a fantasy narrative.
Determine the episode/s to be included in the comic strip.
Design the format for the comic strip, defining spaces for dialogues and descriptions.
Etapa (s) del
Adjust the information to write the dialogues.
producto:
Write brief descriptions for the characters and the events.
Check that the writing of dialogues and descriptions comply with grammar, spelling and punctuation conventions.
Incorporate the dialogues and descriptions in the corresponding spaces of the comic book and illustrate them.
Rehearse the dramatized reading of comic books to check understanding.
Perform a dramatized reading of the comic book.
Articulacin de Contenidos
semana
Actividades
Hacer con el lenguaje
Conditional sentences and second conditional.
Select and explore fantasy narratives.
Identify textual arrangement.
Identify publishing data.
Show students in a card boar the rules of conditional sentences and the different between the conditional ad the
1
Activate previous knowledge to determine topic,
second conditional, activities in the notebook and participate in the class. All ready book 22-27.
purpose, and intended audience
Read fantasy narratives and understand the
general meaning, main ideas, and some
2
details.
Parts of a book, adjectives.
Use different comprehension strategies (e.g., rereading, selfquestioning, vocabulary, text
The teacher is going to show a big image of a book to the students with the parts of the book, the students are
arrangement, etc.).
going to participate in the whiteboard, and start to know what is a comic book and how to make one doindg one in
Clarify meaning of words.
their note books.all ready book pages 28-31.
Identify actions used as names or as
characteristics/qualities (e.g., flying on a
broomstick was wonderful; He carries a lighted
candle).
Distinguish implicit from explicit information.
Recognize events in paragraphs.
Detect words and expressions used to describe
physical features of characters.
Formulate and answer questions to determine
characters actions and abilities.
Describe characters.

Administracin Federal de Servicios Educativos en el Distrito Federal


Direccin General de Innovacin y Fortalecimiento Acadmico
Direccin de Programas de Innovacin Educativa
Coordinacin de Ingls en el Distrito Federal

Express personal reactions to a text (e.g., I didn


t like).
Listen to others opinions to identify different
interpretations.
Complete sentences based on characters
actions and abilities.
Write sentences based on one or more abilities
Saber acerca del lenguaje

Present perfect, past perfect


Topic, purpose, and intended audience.
Colophon: publishing house, year, location, etc.
Elements: characters, events, narrator, etc.
Patterns of textual arrangement.
Repertoire of words necessary for this social
practice of the language.
Adjectives and adverbs of time.
Verb tenses: present and past perfect.
Verb forms: gerund and past participle.
Conditionals.
Direct and indirect speech.
Homophones (e.g., peace/piece and bear/bare).
Differences between British and American
variants

The students are going to learn the different times of the sentences, present and past, and how the
verbs change with them, they are going to understand and put and practice working in the notebook,
work in the all ready book pages 32-33
3

Product 2 (comic book)

The students are going to make up one in teams, selecting a book, they are going to bring
and present. All ready book pages 34-35

Ser con el lenguaje


4
their materials and work in the classroom,
Acknowledge creativity and imagination in the
perception of reality.
Enjoy reading.
Materiales
Book, Notebook, reader, Marks, flashcards, images, paper, wallcharts and worksheets.
educativos
complementarios:
Observaciones:

Nombre del
Director

Firm
a

Fecha

Sello

Administracin Federal de Servicios Educativos en el Distrito Federal


Direccin General de Innovacin y Fortalecimiento Acadmico
Direccin de Programas de Innovacin Educativa
Coordinacin de Ingls en el Distrito Federal

Escuela:
Profesor (a):
Prctica Social:
Competencia Especfica:

Escuela Sec. Lic. Benito Jurez.


Mara Fernanda Anaya Corrales.
Understand and convey information about goods and services

CCT:
Unidad:
Ambiente:

State oral complaints about a health service

Producto Final:

1
Familiar and
community
Telephone complaint
voicemail.

Mes:
Grado:
Grupo (s):

September - Octuber
3rd
A,B,C,D

Tres sesiones de 50 min ala


semana. Secundaria

Learning environment 1
Aprendizajes
Esperados:

Establishes the motive or reason for a complaint.


Infers the general meaning from explicit information.
Distinguishes between main ideas and some details.
Uses strategies to influence on meaning.

Instrumento (s)
de evaluacin:

Rbrica
Lista de cotejo
Anecdotario
Observacin directa
Producciones escritas

Proyectos
Esquemas
Registro de actitudes
Portafolio
Pruebas escritas u orales

Telephonic complaint voice mail


Produce telephonic complaints.
Select and consult information to make a complaint.
Etapa (s) del
Determine the topic or reason to make a complaint.
producto:
Create the statements to express the complaint.
Check that the complaint is understood when said and heard.
Practice the enunciation of the complaint.
Make the complaint
Articulacin de Contenidos
semana
Actividades
Hacer con el lenguaje
Contextual clues and structure of the complains.
Listen to and explore complaints about a
health service.
Identify topic and purpose.
1
The students are going to hear different situations of complaints calls about different services, know the
Establish form of communication.
vocabulary, for structure one in the notebook. Activities in the notebook. All ready book pages 8-10
Determine place or addressee for a complaint.
Distinguish attitudes of speakers.
Detect ways to adjust the actions of speaking
2
and listening: pauses, rhythm, tone, etcetera
Interpret general sense, main ideas, and some
Third conditional and verbs in past
details of a complaint.
Clarify meaning of words.
The students are going to learn about the third conditional, how to used and the structure, making they own
Activate previous knowledge.
sentences in the notebook and different activities. Knowing the time of the verb is in the third conditional. All ready
Infer general sense.
book pages 11-14.
Detect and interpret technical or specialized
information.
Establish motive or reason for a complaint.
Identify main ideas and information that explains
or complements them.
Detect expressions to suggest solutions.
Identify strategies to emphasize meaning
Write an oral complaint.
Choose a suitable word repertoire.
Use and adapt speech register according to the
addressee.
Express motive or reason.
Write expressions to suggest solutions.
Use strategies to influence on meaning.
Use strategies to repair failed communication.

Administracin Federal de Servicios Educativos en el Distrito Federal


Direccin General de Innovacin y Fortalecimiento Acadmico
Direccin de Programas de Innovacin Educativa
Coordinacin de Ingls en el Distrito Federal

Express complaints and make adjustments to


improve fluency.
Saber acerca del lenguaje

Adverbs and adjectives.

Topic, purpose, and intended audience.


Contextual clues.
Structure of complaints: opening, body, and
closure.
Form of communication.
Repertoire of words necessary for this social
practice of the language.
Modal verbs, adverbs, and adjectives.
Acoustic features.
Conditionals.
Verb tenses: present, past, and future.
Connectors.

The students are going to remember the adverbs and adjectives and how to use it, working I the note
book, and participate in the whiteboard in the class, the teacher are going to make a jeopardy with
them and play with the students. All ready pages 15-19
3

Product 1 (Telephone complaint voicemail )


The students are going to make teams of 4 and make a voicemail complaint, about different community service
Ser con el lenguaje
4
and present in front of the class, already book pages 20-21
Stand up for citizens rights.
Become aware of the attitudes of oneself and
others.
Materiales
Book, Notebook, reader, Marks, flashcards, images, paper, wallcharts and worksheets.
educativos
complementarios:
Observaciones:

Nombre del
Director

Firm
a

Fecha

Sello

Administracin Federal de Servicios Educativos en el Distrito Federal


Direccin General de Innovacin y Fortalecimiento Acadmico
Direccin de Programas de Innovacin Educativa
Coordinacin de Ingls en el Distrito Federal

Escuela:
Profesor (a):
Prctica Social:
Competencia Especfica:

Escuela Sec. Lic. Benito Jurez.


Mara Fernanda Anaya Corrales.
Read and understand different literary text distinctive of English-speaking
countries.

CCT:
Unidad:
Ambiente:

1
Literary and ludic

Read suspense literature and describe moods.

Producto Final:

Emotionary.

Mes:
Grado:
Grupo (s):

September - Octuber
3rd
A,B,C,D

Tres sesiones de 50 min ala


semana. Secundaria

Learning environment 2
Uses various strategies to understand narratives.
Rbrica

Proyectos

Infers the general meaning and main ideas from details.


Lista de cotejo

Esquemas

Aprendizajes
Instrumento (s)
Formulates and answers questions in order to infer information.
Anecdotario

Registro de actitudes

Esperados:
de evaluacin:
Writes opinions regarding moods.
Observacin directa
Portafolio

Organizes paragraphs in order to create texts.


Producciones escritas
Pruebas escritas u orales
Emotionary (inventory of emotions)
Select, from a number of sources, a suspense narrative.
Read the selected narrative in silence.
Etapa (s) del
Choose and make a list of emotions that the narrative presents or provokes.
producto:
Propose and write examples of the situations that describe the emotions.
Check that the examples comply with grammar, spelling, and punctuation conventions.
Organize an event to present and read the emotionary.
Articulacin de Contenidos
semana
Actividades
Hacer con el lenguaje
Comparatives and superlatives.
Select and explore suspense narratives.
Identify textual arrangement.
Determine topic and purpose.
1
Are going to search what is comparatives and superlatives, the teacher are going to explain for what they can use
Detect intended audience from explicit
it and were, they are going to formulate sentences in the notebook, and read deferent stories. , All ready book
information.
pages 22-26
Understand general sense, main ideas, and
some details of a suspense narrative.
Read and re-read narratives.
Use diverse comprehension strategies.
Nouns and pronouns in plural
Detect frequently used words.
Make links within texts using explicit and implicit
The students are going to bring a list of pronouns and nouns, the teacher are going to explain ad make it plural,
information.
make different activities in the notebook, use the reader book pages 20-29 and all ready book pages 27-29
Infer main ideas from details.
Answer questions to infer characters moods
from explicit information.
Relate moods to specific moments in a narrative.
2
Describe characters moods in a suspense
narrative.
Express and justify personal impressions
towards a text.
Relate moods to characters.
Make sentences from words that express
moods.
Complete sentences to express moods.
Describe characters moods.
Saber acerca del lenguaje
3

Administracin Federal de Servicios Educativos en el Distrito Federal


Direccin General de Innovacin y Fortalecimiento Acadmico
Direccin de Programas de Innovacin Educativa
Coordinacin de Ingls en el Distrito Federal

Emotions

Elements in narratives.
Repertoire of words necessary for this social
practice of the language.
Types of sentences.
Adjectives: comparative and superlative.
Pronouns: reflexive and relative.
Conditionals.
Homophones (e.g., too and two).
Upper and lower-case letters.

The teacher are going to tell a story and going to ask what the student feel about it and describe they
emotion, then they are going to bring to the class a list with different emotion, and then they are ging
to read different stories and they are going to put were the emotion go, and make the draws in the
notebook, all readt book pages 30-33

Product 2 (Emotionary )
The students are going to bring different materials and do a big list with draws with diferent emotion, they are
Ser con el lenguaje
4
going to star in the class and work there, working with the book pages 34-35, and for the end of the week present
Foster respect towards the opinions of others.
the work
Stimulate an aesthetic pleasure for literature.
Develop empathy towards different moods.
Materiales
Book, Notebook, reader, Marks, flashcards, images, paper, wallcharts and worksheets.
educativos
complementarios:
Observaciones:

Nombre del
Director

Firm
a

Fecha

Sello

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