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ANEXO 1FORMULARIO N1

INSTITUCIN: Colegio Gran Bretaa ,Concepcin REGIN: Bio bio TELFN:

!IRECCIN: "an#el B#lne$ %&' CIU!(!: Concepcin

N"BRES ()ELLI! )(TERN ()ELLI! "(TERN RUT E!(!

* )ablo (n+r$ Fig#eroa Ce$pe+e$ -'./%&.-'01* *2

- "arcelo 3la+i4ir (rena$ "ac5#ca -'.-26.*-*10 *2

0 7e$8$ Seba$ti9n )ar+o Correa -'.2'.02%1; *2

/ Ba$ti9n Ignacio Gaete 3alena Sc5ein?elt-'.*2&.0-'1 *2

% Seba$ti9n (n+r$ (larcn C59>e< -'.***.-'1/ *&

=ector Ignacio Torre$ Fern9n+e< -'.'--.%/21; *&

6 7ere4ia$ "at#

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N"#$%& D'%&()"% T*(+'(","+/" T"%%& &+/& N"#$%& &&", "%& C%)&T&*"+", C& 88800518N"#$%& '%&()"% & ("&'",S% A# C"+(

T&*"+",2E:006 C&%, 62486226 M',

C"#&+)%'",

F'%# & D'%&()"%, N"#$%& & &)$&('#'&+)",C"&'" %+ ;%&)

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N"BRE ()!ER(! RUT FIR"(

Carolina C$pe+e$ *0.66%.2%61'Leticia Il#?i *0.2'%.*%-1-

"aribel Correa **.0%'./021%

(le Gaete */./2*.0-61'olan+a Gon

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y cmp!eta aceptacin de! re$!ament y bases& a !s re'"isits densabi!idades a Cca-C!a de Chi!e .A.& !s embte!!adresprestar cnsentimient ante hspita!es y mdics para c"a!'"ierh a cntraprestacin a!$"na.

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