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ICJ – INSTITUTO DE CIÊNCIAS JURÍDICAS 
CURSO DE DIREITO 
SETOR DE ATIVIDADES COMPLEMENTARES Port. Rec. nº. 550 
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: _______________________________________ 
 
ICJ – INSTITUTO DE CIÊNCIAS JURÍDICAS 
CURSO DE DIREITO 
RELATÓRIO DE ATIVIDADE 
 
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