Sol·licitud de Rotació Rural del Resident (enviar a la UD de Barcelona: [email protected] amb com a mínim 2 mesos d’antelació a la data sol·licitada)

Nom i Cognoms del/la resident:

Centre Docent al que pertany: Indicar el centre al que opta a fer la rotació rural dels centres acreditats per l’IES i que consten a la llista adjunta. Pot escollir un o més centres fins a 3 com a màxim indicant l’ordre de prioritat (1 prioritat màxima) Centre de rotació 1: Centre de rotació 2: Centre de rotació 3: Mes en que demana la rotació rural: Indicar si es vol optar a un mes complementari com a rotació opcional. (2 mesos en total)

Signatura resident:

Signatura Coordinador Docent:

MODEL SOL.LICITUD ROTACIO RURAL 2016.pdf

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