e Field A ddress & Phon e / Fa x Fie ld DI N · EN RO LM EN T FORM We s tern Ba y of Plent y PHO -...
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M R O F T N E M L O R N E O H P y t n e l P f o y a B n r e t s e W - m r o F t n e m l o r n E r e d i v o r P s e c i v r e S h t l a e H y r a m i r P t n a i l p m o C S E N 7 1 0 2 h c r a M e m a N e c i t c a r P d l e i F d l e i F x a F / e n o h P & s s e r d d A r e d i v o r P C M Z N I D E ) r e f s n a r T e l i F c i n o r t c e l E P G o t P G ( I H N * t a h t s d l e i F s e t a c i d n I Y R A S L U P M O C e r a e s U e c i f f O r o f e v o b a s d l e i F Y L N O l a g e L e m a N e l t i T / e m a n r u S e m a N y l i m a F * n e v i G / t s r i F e m a N * ) s ( e m a N e l d d i M * e m a N d e r r e f e r P e m a N n e d i a M s l i a t e D h t r i B h t r i B f o r a e Y / h t n o M / y a D * h t r i B f o e c a l P * f o y r t n u o C B h t r i * r e d n e G e l a M e l a m e F ) e t a t s e s a e l p ( e s r e v i d r e d n e G * e g a u g n a L y r a m i r P l a u s U l a i t n e d i s e R s s e r d d A e m a N t e e r t S d n a r e b m u N ) D I P A R r o ( e s u o H * b r u b u S l a r u R / n o i t a c o L * n w o T / e d o c t s o P d n a y t i C * l a t s o P s s e r d d A ) e v o b a m o r f t n e r e f f i d f i ( e m a N t e e r t S d n a r e b m u N e s u o H r e b m u N x o B O P r o b r u b u S l a r u R / y r e v i l e D n w o T / e d o c t s o P d n a y t i C s l i a t e D t c a t n o C e n o h P e l i b o M e n o h P e m o H s s e r d d A l i a m E / n i K f O t x e N y c n e g r e m E t c a t n o C e m a N p i h s n o i t a l e R e n o h P ) r e h t o r o ( e l i b o M s s e r d d A y t i n u m m o C d r a C s e c i v r e S s e Y o N y r i p x E f o r a e Y / h t n o M / y a D d r a C r e b m u N ) n w o n k f i ( r e s U h g i H d r a C h t l a e H s e Y o N y r i p x E f o r a e Y / h t n o M / y a D r e b m u N d r a C ) n w o n k f i ( f o r e f s n a r T s d r o c e R y t i r o h t u A . r o t c o D s u o i v e r p y m m o r f s d r o c e r y m g n i n i a t b o e c i t c a r P e h t o t e e r g a I , e l b i s s o p e r a c t s e b e h t t e g o t r e d r o n I . Z N n i e m i t a t a e c i t c a r p 1 t a d e l l o r n e e b o t e l b a y l n o m a I s a , r e t s i g e r e c i t c a r p r i e h t m o r f d e v o m e r e b l l i w I d n a t s r e d n u I s e Y - e s a e l p s d r o c e r y m f o r e f s n a r t t s e u q e r e l b a c i l p p A t o N o N e m a N e c i t c a r P r o / d n a r o t c o D s u o i v e r P e r u t a n g i S r a e Y / h t n o M / y a D e c i t c a r P n o i t a c o L / s s e r d d A y t i c i n h t E s l i a t e D c i n h t e h c i h W u o y o d ) s ( p u o r g ? o t g n o l e b * e c a p s e h t k c i T s e c a p s r o o t y l p p a h c i h w u o y d n a l a e Z w e N n a e p o r u E i r o a M n a o m a S i r o a M d n a l s I k o o C n a g n o T e u i N an e s e n i h C n a i d n I , h c t u D s a h c u s ( r e h t O . ) n a u a l e k o T , e s e n a p a J e t a t s e s a e l P : I W I n o i t a p u c c O r e y o l p m E s s e r d d A & s u t a t S g n i k o m S r e v o & s r a e y 5 1 o t s e i l p p a ( Y L N O ) d e k o m s r e v e N r e k o m s t n e r r u C x E- r e k o m s _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ e t a D t i u Q e t a m i x o r p p A ? t i u q o t t r o p p u s e k i l u o y d l u o W s e Y o N t n e s n o C v s n o i t a c i n u m m o C e v i e c e R o t a i l i a m E - t x e T - l a t r o P t n e i t a P f i ( ) e l b a l i a v a r u o y e v i g o t s e x o b e l b a c i l p p a k c i t e s a e l P o cn t n e s : e g a s s e M t x e T ) e r u c e s ( l a t r o P t n e i t a P n o n ( l i a m E - ) e r u c e s
Transcript of e Field A ddress & Phon e / Fa x Fie ld DI N · EN RO LM EN T FORM We s tern Ba y of Plent y PHO -...
MROF TNEMLORNE
OHP ytnelP fo yaB nretseW - mroF tnemlornE redivorP secivreS htlaeH yramirP tnailpmoC SEN 7102 hcraM
emaN ecitcarP dleiF dleiF xaF / enohP & sserddA
redivorP CMZN IDE )refsnarT eliF cinortcelE PG ot PG( IHN
* taht sdleiF setacidnI YRASLUPMOC era esU eciffO rof evoba sdleiF YLNO
lageLemaN
eltiT
/emanruS emaN ylimaF *
neviG/tsriF emaN *
)s(emaN elddiM * emaN derreferP emaN nediaM
sliateD htriB
htriB fo raeY / htnoM / yaD * htriB fo ecalP * fo yrtnuoC B htri *
redneG elaM elameF )etats esaelp( esrevid redneG * egaugnaL yramirP
lausU laitnediseRsserddA
emaN teertS dna rebmuN )DIPAR ro( esuoH * brubuS laruR/ noitacoL * nwoT / edoctsoP dna ytiC *
latsoP sserddA )evoba morf tnereffid fi(
emaN teertS dna rebmuN esuoH rebmuN xoB OP ro brubuS laruR/ yrevileD nwoT / edoctsoP dna ytiC
sliateD tcatnoC
enohP eliboM enohP emoH sserddA liamE
/ niK fO txeN ycnegremE
tcatnoC
emaN pihsnoitaleR enohP )rehto ro( eliboM
sserddA
ytinummoC draC secivreS
seY oN yripxE fo raeY / htnoM / yaD draC rebmuN )nwonk fi(
resU hgiH draC htlaeH
seY oN yripxE fo raeY / htnoM / yaD rebmuN draC )nwonk fi(
fo refsnarTsdroceR
ytirohtuA
.rotcoD suoiverp ym morf sdrocer ym gniniatbo ecitcarP eht ot eerga I ,elbissop erac tseb eht teg ot redro nI .ZN ni emit a ta ecitcarp 1 ta dellorne eb ot elba ylno ma I sa ,retsiger ecitcarp rieht morf devomer eb lliw I dnatsrednu I
seY - esaelp sdrocer ym fo refsnart tseuqer
elbacilppA toN oN
emaN ecitcarP ro/dna rotcoD suoiverP
erutangiS raeY / htnoM / yaD ecitcarP noitacoL / sserddA
yticinhtEsliateD
cinhte hcihW uoy od )s(puorg
?ot gnoleb *
ecaps eht kciT secaps ro
ot ylppa hcihwuoy
dnalaeZ weN naeporuE
iroaM
naomaS
iroaM dnalsI kooC
nagnoT
euiN an
esenihC
naidnI
,hctuD sa hcus( rehtO.)naualekoT ,esenapaJ
etats esaelP :
IWI
noitapuccO
reyolpmE sserddA &
sutatS gnikomS revo & sraey 51 ot seilppa ( YLNO ) dekoms reveN rekoms tnerruC
xE - rekoms ____________________etaD tiuQ etamixorppA
?tiuq ot troppus ekil uoy dluoW seY oN
tnesnoC v snoitacinummoC evieceR ot ai liamE - txeT - latroP tneitaP fi( )elbaliava ruoy evig ot sexob elbacilppa kcit esaelP oc n tnes :
egasseM txeT )eruces( latroP tneitaP
non( liamE - )eruces
MROF TNEMLORNE
OHP ytnelP fo yaB nretseW - mroF tnemlornE redivorP secivreS htlaeH yramirP tnailpmoC SEN 7102 hcraM
* yM fo noitaralced dna tnemeltitne ytilibigile * I lorne ot deltitne ma .dnalaeZ weN ni yltnenamrep gnidiser ma I esuaceb
en eht ni syad 381 tsael ta rof dnalaeZ weN ni tnediser eb ot dnetni uoy taht si ZN ni yltnenamrep gnidiser fo noitinifed ehT shtnom 21 tx
lorne ot elbigile ma I :esuaceb
a nezitic dnalaeZ weN a ma I ( ,sey fI dna xob kcit ot deecorp ytilibigile ym fo foorp edivorp nac I ,detseuqer fi ,taht mrifnoc I woleb ) era uoy fI ton nezitic dnalaeZ weN a hcihw kcit esaelp e ytilibigil airetirc seilppa uoy ot (b–j) :woleb
b a dloh I )0102 rebmeceD erofeb deussi fi timrep ecnediser a ro( asiv tnediser tnenamrep a ro asiv tnediser c ro dnalaeZ weN ni neeb evah I wohs ot elba DNA tnediser tnenamrep nailartsuA ro nezitic nailartsuA na ma I
2 tsael ta rof dnalaeZ weN ni yats ot dnetni sraey evitucesnoc
d suoiverp( sraey 2 tsael ta rof dnalaeZ weN ni eb ot elba ma I taht wohs nac dna timrep/asiv krow a evah I)dedulcni stimrep
e detrats asiv miretni ym erofeb yletaidemmi elbigile saw ohw redloh asiv miretni na ma I f a ma I noitcetorp ro eegufer gnilaeppa ro ,rof gniylppa fo ssecorp eht ni RO nosrep detcetorp ro eegufer
gnikciffart elpoep fo mitciv detcepsus ro mitciv a RO ,sutats
g tnerap gnitpoda/naidraug lagel/tnerap a fo lortnoc dna erac eht ni dna sraey 81 rednu ma I ohw eno steema sesualc ni noiretirc –f evoba RO tnempoleveD laicoS fo yrtsiniM eht fo evitucexE feihC eht fo lortnoc eht ni
h ro( gnidnuf ecnatsissA tnempoleveD laiciffO gniviecer dna ZN ni gniyduts tneduts emmargorP diA ZN a ma Idlihc ro rentrap rieht )dlo sraey 81 rednu
i emehcs pihstnatsissA gnihcaeT egaugnaL ngieroF noitacudE fo yrtsiniM eht ni gnitapicitrap ma I j ytisrevinu dnalaeZ weN a morf gnidnuf gniviecer dna ZN ni gniyduts redloh pihsralohcS htlaewnommoC a ma I
htlaewnommoC eht rednu dnuF pihswolleF dna pihsralohcS
mrifnoc I evah I taht edivorp d ytilibigile ym fo foorp dethgis ecnedivE ( ylno esu eciffO )
ssecorp tnemlorne eht ot tnemeerga yM sraey 61 rednu era uoy fi ngis ot revigeraC ro tneraP .BN
ecitcarp siht esu ot dnetni I sa no dna raluger ym - .secivres erac htlaeh / PG / ecitcarp lareneg fo redivorp gniog dnatsrednu I htiw gnillorne yb taht tresni( ecitcarp )eman eb lliw I eht ni dedulcni dellorne fo noitalupop ytnelP fo yaB nretseW
OHP a ym dn eman , no dedulcni eb lliw sliated noitacifitnedi rehto dna sserdda t ecitcarP eh , OHP dna ecivreS tnemlornE lanoitaNretsigeR s.
dnatsrednu I rehtona tisiv I fi taht erac htlaeh .eef rehgih a degrahc eb yam I dellorne ton ma I erehw redivorp noitamrofni nevig neeb evah I demrofni ro tnemlorne fo snoitacilpmi dna stifeneb eht tuoba dna ecitcarp siht secivres eht dna
eht htiw gnola sedivorp OHP s’OHP dna eman .sliated tcatnoc eerga I dna daer evah I eht htiw fo esU .tnemetatS noitamrofnI htlaeH mroF tnemlornE eht no dedivorp evah I noitamrofni ehT
ylcilbup eviecer ot ytilibigile enimreted ot desu eb lliw - tnemnrevog rehto htiw derapmoc eb yam noitamrofnI .secivres dednufseicnega , .tcA ycavirP eht rednu dettimrep nehw ylno tub
dnatsrednu I taht erac llarevo rieht woh dna ecneirepxe erac htlaeh s’elpoep tuoba yevrus lanoitan a ni setapicitrap ecitcarP ehtb yevrus eht fo tuo tpo ro yevrus eht enilced nac I .suomynona eb lliw sesnopser lla dna yratnulov si trap gnikaT .deganam si y
arP eht gnimrofni .secivres htlaeh evorpmi ot desu si taht noitamrofni tnatropmi sedivorp yevrus ehT .ecitc eerga I ym ni segnahc yna fo ecitcarp eht mrofni ot sliated tcatnoc tnemeltitne dna ro/dna ytilibigile dellorne eb ot .
I ga eer fo edarT fo snoitidnoC dna smreT eht ot ( eman ecitcarp tresni ot ekatrednu dna ) yap yna seef rof elbacilppa P ecitcarsecivreS & lla derrucni stsoc fo noitcelloc ni yna tbed rof flesym stnedneped ym & .
sliateD yrotangiS
erutangiS * raeY / htnoM / yaD * fleS - gningiS ytirohtuA
ytirohtua nA .flaheb nwo rieht no tnesnoc ot elbanu era yeht nosaer emos rof fi nosrep rehtona rof ngis ot thgir lagel eht sah
sliateD ytirohtuA si yrotangis erehw(
gnillorne eht ton)nosrep
lluF emaN pihsnoitaleR enohP tcatnoC
fo sisaB )ega fo sraey 61 rednu dlihc a fo tnerap .g.e( ytirohtua
MROF TNEMLORNE
OHP ytnelP fo yaB nretseW - mroF tnemlornE redivorP secivreS htlaeH yramirP tnailpmoC SEN 7102 hcraM
MROF TNEMLORNE
OHP ytnelP fo yaB nretseW - mroF tnemlornE redivorP secivreS htlaeH yramirP tnailpmoC SEN 7102 hcraM
eriannoitseuQ tneitaP weN arouaH uhaK itagN elbissop sa ylluf sa eriannoitseuq eht etelpmoc esaelP
emaN htriB fo etaD etaD syadoT
yrotsiH lacideM lanosreP :dah reve uoy evaH rojam ynA :snoitarepo ro ssenlli
woleb tsil esaelP anigna ro skcatta traeH N/Y
)AIT(ekortsiniM ro ekortS N/Y erusserP doolB hgiH N/Y
setebaiD N/Y amhtsA N/Y yspelipE N/Y
recnaC N/Y sititapeH N/Y
yrotsiH lacideM ylimaF ro srehtorb dna stnerap( )sretsis tesno fo ega dna ssenlli tnacifingis yna ebircsed esaelP
?ega sry56 erofeb skcatta traeh fo yrotsih ylimaf yna ereht sI N/Y
senicideM dna sgurD ekat uoy taht stnemelppus dna senicidem lla tsil esaelP
eh/tsimehc a ta thguob esoht gnidulcni( )pohs htla emaN esoD nekat yeht era netfo woH
seigrella yna morf reffus uoy oD ? )stcudorp rehto ro sgurd( ygrella ebircsed esaelP
sutatS gnikomS rekomsnoN rekomsxE rekoms tnerruC
?pots uoy did nehW ot ekil uoy dluoW N/Y ?pots
seidaL nehW :tsal ruoy saw raems lacivreC margommaM
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