ࡱ> ikfgh bjbjR|R| >:00$ 804Af 1111<3*44Hz@|@|@|@|@|@|@$-CE*@4<3<344@11HA<<<4:11z@<4z@<<<1@(L85:<f@A0A< Fr5N F<<& F<44<44444@@<444A4444 F444444444 : OCFS-6027 (09/2016)NEW YORK STATE OFFICE OF CHILDREN AND FAMILY SERVICES CHILD CARE ATTENDANCE SHEET  SEVEN DAYS  Page  FORMTEXT       of  FORMTEXT       Facility ID: FORMTEXT      Month:  FORMTEXT      Year:  FORMTEXT      Program:  FORMTEXT      INSTRUCTIONS: Actual times in and out must be recorded in the spaces below. Check box if child is absent. Daily health care check must be checked after conducted. If there are health care concerns, notes must be recorded and kept confidential. Child s Name MONDAY Date: FORMTEXT      / FORMTEXT      / FORMTEXT      TUESDAY Date: FORMTEXT      / FORMTEXT      / FORMTEXT      WEDNESDAY Date  FORMTEXT      / FORMTEXT      / FORMTEXT      THURSDAY Date: FORMTEXT      / FORMTEXT      / FORMTEXT      FRIDAY Date: FORMTEXT      / FORMTEXT      / FORMTEXT      SATURDAY Date: FORMTEXT      / FORMTEXT      / FORMTEXT      SUNDAY Date: FORMTEXT      / FORMTEXT      / FORMTEXT      First Name  FORMTEXT       FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health checkLast Name  FORMTEXT      INOUTINOUTINOUTINOUTINOUTINOUTINOUT FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT        FORMTEXT       FORMTEXT      DOB: FORMTEXT      / FORMTEXT      / FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      First Name  FORMTEXT       FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health checkLast Name  FORMTEXT       INOUTINOUTINOUTINOUTINOUTINOUTINOUT FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT        FORMTEXT       FORMTEXT      DOB: FORMTEXT      / FORMTEXT      / FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      First Name  FORMTEXT       FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health checkLast Name  FORMTEXT      INOUTINOUTINOUTINOUTINOUTINOUTINOUT FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT        FORMTEXT       FORMTEXT      DOB: FORMTEXT      / FORMTEXT      / FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      First Name  FORMTEXT       FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health checkLast Name  FORMTEXT      INOUTINOUTINOUTINOUTINOUTINOUTINOUT FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       "$&(   ζzn\N9\)jh?vphfAg5>*U^JaJh?vphfAg5>*^JaJ#jh?vphfAg5>*U^JaJh?vphfAg;^JaJhhfAg;^JaJhhfAg5^JaJhfAg5CJ^JaJhhfAg5CJ^JaJhhfAg^JaJhhfAg;CJ^JaJh2JSCJ^JaJhhfAgCJ^JaJhu5CJ^JaJhhfAg5CJ^JaJhfAg5CJ^JaJ(FT n  \:x$IfgdfAg \::x$If]:gdfAg \:x$If^gdfAg$d$Ifa$gd~$d$Ifa$gdEa \:($If^gd0N     $ & : < > H J L R T j l n p ʾְ־zn_TB_#jhfAghfAgU^JaJhfAghfAg^JaJjhfAghfAgU^JaJhhfAg5^JaJh?vphfAg5^JaJhhfAg;^JaJhfAg;^JaJ)jth?vphfAg5>*U^JaJh?vphfAg5>*^JaJh?vphfAg;^JaJhC,hfAg5^JaJ#jh?vphfAg5>*U^JaJ.jh?vphfAg5>*U^JaJmHnHu   ɽzeYGeY#jhhtCU^JaJhhtC5^JaJ(jhhtCU^JaJmHnHu#j5hhtCU^JaJhhtC^JaJjhhtCU^JaJhhtC^JaJhhtC5^JaJhh[5^JaJ hhfAghfAghfAg;^JaJjhfAghfAgU^JaJ(jhfAghfAgU^JaJmHnHu Q9%dP$If^gd0Ndx$If]^gd0Nkd\$$Ifl4r(04:`( t644 la p2yt0N   & N  BdP$IfgdCdx$If]^gdfAg$dP$Ifa$gdEadP$If^gd0Ndx$If]^gd0N  & ( < > @ J L N P h j l f h x ͹٣͜ynfn[f[P[n[Ehh ^^JaJhhL^JaJhhN}^JaJh?vp^JaJhh^JaJh?vp5^JaJhhs5^JaJhhs5>*^JaJ hh+jhhtC5U^JaJmHnHu&jhhtC5U^JaJhhtC5^JaJ jhhtC5U^JaJhhtC5^JaJhQ5^JaJN P !kd$$Ifl4֞$ (Y+: E t644 la pFyt0N 8 : <        * , . 8 : < > R T V ` b r ~ ι¹{j{Y¹ jh55U^JaJ jh55U^JaJh5hM5^JaJ%jh55U^JaJmHnHu jh55U^JaJjh55U^JaJh55^JaJhhM5^JaJhhM5^JaJhh}.^JaJhh ^^JaJhya9^JaJhJ^JaJ"P < d v &ll$d$If]^a$gd5$d$If]^a$gd5$d$If]^a$gd5$d$If]^a$gd5$dx$Ifa$gdi.d((^`gd0N .02<>@BVXZdfh׸׸׸~m׸\׸ jh55U^JaJ jhh55U^JaJhhM5^JaJhhM5^JaJ jh55U^JaJ j|h55U^JaJh5hM5^JaJ%jh55U^JaJmHnHujh55U^JaJ jh55U^JaJh55^JaJ$hj~"$2>@BVXZn] j, h55U^JaJ j h55U^JaJ j@ h55U^JaJh5hM5^JaJ jh55U^JaJhhM5^JaJhhM5^JaJ%jh55U^JaJmHnHu jTh55U^JaJh55^JaJjh55U^JaJ$&6N\lTd($If]^gd5d$If]^gd5Ffs$ d$If]^a$gd5 $ )d$If]^a$gd5$d$If]^a$gd5$d$If]^a$gd5 Zdfhj~"$&(<>ɸɧޛ~m\ jz h55U^JaJ j h55U^JaJ j h55U^JaJhhM5^JaJhhM5^JaJ j h55U^JaJ j h55U^JaJh55^JaJh5hM5^JaJjh55U^JaJ%jh55U^JaJmHnHu$>@JLZ\fh|~ Ǿxk]Thm5^JaJjhm5U^JaJhi.hmCJ ^JaJ hh j h55U^JaJ jf h55U^JaJh5hM5^JaJ j h55U^JaJh55^JaJhhM5^JaJhhM5^JaJ%jh55U^JaJmHnHujh55U^JaJ  <>@BRTprtv± ±±~±m±\± jhm5U^JaJ jchm5U^JaJ jhm5U^JaJ j{hm5U^JaJ jhm5U^JaJ jhhm5U^JaJhhm5^JaJ%jhm5U^JaJmHnHujhm5U^JaJ jhm5U^JaJ$R>Yy )*4$ d(($Ifa$gdfAgdL(($If]^gd5d$If]^gd5Ffd($Ifgd~-./0>?MNOPYZhijkyzn jhm5U^JaJ jhm5U^JaJ jhm5U^JaJ j3hm5U^JaJ jhm5U^JaJ jhhm5U^JaJjhm5U^JaJ jKhm5U^JaJhhm5^JaJ%  )*45?@   "(ijĢětaSSSShhm5>*^JaJ%jhm5U^JaJmHnHu jhm5U^JaJhm5^JaJhi.hmCJ ^JaJ hhm jhm5U^JaJ jwhm5U^JaJhhm5^JaJ jhhm5U^JaJjhm5U^JaJ jhm5U^JaJ "*08>FLTZbhprtd$If]^gd5Ffd(($If^gdfAg$ d(($Ifa$gdfAg$d(($Ifa$gdfAg(*.068<>DFJLRTfhnprtvn&j"hhm5U^JaJ&j!hhm5U^JaJ+jhhm5U^JaJmHnHu&j.!hhm5U^JaJ jhhm5U^JaJhi.hmCJ ^JaJ hh0Nhhm5>*^JaJhhm5^JaJ*t<d,8`b^d(($If]^^gd~$d(($If]^a$gd~$d(($If]^a$gd~$d(($If]^a$gd~*,.8:<>RTV`bdfz|~۹۹۝۹۝۹u۝۹a۝۹&jZ$hhm5U^JaJ&j#hhm5U^JaJ&jr#hhm5U^JaJhhm5&j"hhm5U^JaJhhm5^JaJ+jhhm5U^JaJmHnHu jhhm5U^JaJ&j"hhm5U^JaJ#(*8:NPR\^bdxz|۽۱۽۱۱۱u۱۱a۽۱&j&hhm5U^JaJ&j*&hhm5U^JaJ&j%hhm5U^JaJ&jB%hhm5U^JaJhhm5^JaJhhm5+jhhm5U^JaJmHnHu jhhm5U^JaJ&j$hhm5U^JaJ#  "$&0246۽{j{Y{Mhhm5^JaJ jt-h.^5U^JaJ j -h.^5U^JaJ%jh.^5U^JaJmHnHu j,h.^5U^JaJjh.^5U^JaJh.^5^JaJ hh0Nhhm5+jhhm5U^JaJmHnHu jhhm5U^JaJ&j'hhm5U^JaJ4\$Lty^d(($If]^^gd~$d(($If]^a$gd~$d(($If]^a$gd~$d(($If]^a$gd~d($If]^gd5FfC)6JLNXZ\^rtvθθθ|θhθ&j/hhm5U^JaJ&j:/hhm5U^JaJ&j.hhm5U^JaJ&jR.hhm5U^JaJ+jhhm5U^JaJmHnHu jhhm5U^JaJ&j-hhm5U^JaJhhm5^JaJ$ "$&:<>HJLNbdfprtv۹۹۹۹۹۹}۹۹i۹۹&j1hhm5U^JaJ&j~1hhm5U^JaJ&j 1hhm5U^JaJ&j0hhm5U^JaJhhm5^JaJ+jhhm5U^JaJmHnHu jhhm5U^JaJ&j"0hhm5U^JaJ#*,.8:<>RTV`bdfz|~۹۹۹۹۹۹}۹viX jh6hm5U^JaJhi.hmCJ ^JaJ hh0N&j3hhm5U^JaJ&jN3hhm5U^JaJ&j2hhm5U^JaJhhm5^JaJ+jhhm5U^JaJmHnHu jhhm5U^JaJ&jf2hhm5U^JaJ<df| 'Ga1Ld($Ifgd~d(($If]^gd5d$If]^gd5Ff5$d(($If]^a$gd~~  '(678θά|k|Z|I| j%;hm5U^JaJ j:hm5U^JaJ j=:hm5U^JaJjhm5U^JaJ j9hm5U^JaJ jhhm5U^JaJhhm5^JaJ+jh6hm5U^JaJmHnHu jh6hm5U^JaJ&jS9h6hm5U^JaJh6hm5^JaJ89GHVWXYabpqrso j=hm5U^JaJ ji=hm5U^JaJ j<hm5U^JaJ j<hm5U^JaJ j <hm5U^JaJjhm5U^JaJ j;hm5U^JaJhhm5^JaJ jhhm5U^JaJ( !"#12@ABCLM[\]^lmvwxijĢđĊ}pgV j`Chm5U^JaJhm5^JaJhi.hmCJ ^JaJhi.hmCJ ^JaJ hhm j?hm5U^JaJ j9?hm5U^JaJ j>hm5U^JaJhhm5^JaJ jhhm5U^JaJjhm5U^JaJ jQ>hm5U^JaJLlmw$,2:@HNV\$d(($Ifa$gd~$ d(($Ifa$gd~d(($If]^gd5dL$If]^gd5FfBAd($Ifgd~  "$*,028:>@FHLNTVhjprtvx÷÷÷÷÷÷÷÷÷÷÷÷j+jhhm5U^JaJmHnHu&jHhhm5U^JaJ jhhm5U^JaJhi.hm^JaJ hh0Nhhm5^JaJhhm5>*^JaJhi.hmCJ ^JaJjhm5U^JaJ%jhm5U^JaJmHnHu&\djrtvnn$d(($If]^a$gd~$d(($If]^a$gd~d$If]^gd5FfE$d(($Ifa$gd~$ d(($Ifa$gd~d(($If^gd~ ,.0:<>@TVXbd۷۫۫۫۫۫og۫S&j4Khhm5U^JaJhhm5&jJhhm5U^JaJ&jLJhhm5U^JaJ&jIhhm5U^JaJhhm5^JaJhhm5>*^JaJ+jhhm5U^JaJmHnHu jhhm5U^JaJ&jdIhhm5U^JaJ >f.:bd6yd($If]^gd5FfQ^d(($If]^^gd~$d(($If]^a$gd~$d(($If]^a$gd~$d(($If]^a$gd~dfh|~ *,:<ڜڈt`&jxMhhm5U^JaJ&jMhhm5U^JaJ&jLhhm5U^JaJ&jLhhm5U^JaJ+jhhm5U^JaJmHnHu&jKhhm5U^JaJhhm5^JaJ jhhm5U^JaJhhm5%<PRT^`dfz|~θθΜθΜxjxYjF%jh.^5U^JaJmHnHu jbTh.^5U^JaJjh.^5U^JaJh.^5^JaJ hh0N&jNhhm5U^JaJhhm5&j`Nhhm5U^JaJ+jhhm5U^JaJmHnHu jhhm5U^JaJ&jMhhm5U^JaJhhm5^JaJ  $&(2468LNPZ\^`tvx򨗋waMa&jVhhm5U^JaJ+jhhm5U^JaJmHnHu&jUhhm5U^JaJhhm5^JaJ jhhm5U^JaJhhm5^JaJ j6Uh.^5U^JaJ%jh.^5U^JaJmHnHu jTh.^5U^JaJh.^5^JaJjh.^5U^JaJ6^& N v !>!f!h!Ff]^d(($If]^^gd~$d(($If]^a$gd~$d(($If]^a$gd~$d(($If]^a$gd~    " $ & ( < > @ J L N P d }i&jXXhhm5U^JaJ&jWhhm5U^JaJ&jpWhhm5U^JaJ&jVhhm5U^JaJ+jhhm5U^JaJmHnHu&jVhhm5U^JaJhhm5^JaJ jhhm5U^JaJ%d f h r t v x !!!!!!!,!۹۹۹۹۹۹}۹۹i۹۹&jZhhm5U^JaJ&j(Zhhm5U^JaJ&jYhhm5U^JaJ&j@Yhhm5U^JaJhhm5^JaJ+jhhm5U^JaJmHnHu jhhm5U^JaJ&jXhhm5U^JaJ#,!.!0!:!!@!T!V!X!b!d!f!h!|!~!!!!!!!!!!!!!!!!۹۹۹~p۹_Q۹۹jhm5U^JaJ jahm5U^JaJjhmUmHnHujahmUjhmUhmhi.hmCJ hh0N&j[hhm5U^JaJhhm5^JaJ+jhhm5U^JaJmHnHu jhhm5U^JaJ&j[hhm5U^JaJh!~!!! "("H"b""""""#2#M#m#n#x#d$If]^gd5Ffid($Ifgd~d(($If]^gd5d$If]^gd5!!!! """"""(")"7"8"9":"H"I"W"X"Y"Z"b"c"q"r"s"t""""""""""ijĢđĀo jCdhm5U^JaJ jchm5U^JaJ j[chm5U^JaJ jbhm5U^JaJ jsbhm5U^JaJhhm5^JaJ jhhm5U^JaJjhm5U^JaJ jahm5U^JaJ$""""""""""""""""""### ###!#"###$#2#3#A#B#C#D#M#N#\#ijĢđĀo jfhm5U^JaJ jfhm5U^JaJ jfhm5U^JaJ jehm5U^JaJ j+ehm5U^JaJhhm5^JaJ jhhm5U^JaJjhm5U^JaJ jdhm5U^JaJ$\#]#^#_#m#n#w#x#y###$ $ $$$$$$ $"$($*$.$0$6$8$<$>$D$F$J$L$R$T$f$h$n$p$Ľᜋxjjjjjjjjjjjjhhm5>*^JaJ%jhm5U^JaJmHnHu j"khm5U^JaJhm5^JaJhi.hm^JaJhi.hmCJ ^JaJ hhmhhm5^JaJ jhhm5U^JaJjhm5U^JaJ joghm5U^JaJ&x#$$$"$*$0$8$>$F$L$T$Z$b$h$p$r$FfUmd(($If^gd~$d(($Ifa$gd~$ d(($Ifa$gd~dL(($If]^gd5p$r$t$v$$$$$$$$$$$$$$$$$$$$$$%%%%%%%*%ѽݧѓݧ݅qݧ]ݧ&jrhhm5U^JaJ&jqhhm5U^JaJhhm5>*^JaJ&j&qhhm5U^JaJ+jhhm5U^JaJmHnHu&jphhm5U^JaJhhm5^JaJ jhhm5U^JaJhi.hm^JaJ hh0N r$t$$$$%<%d%%%%&,&8&`&~^d(($If]^^gd~$d(($If]^a$gd~$d(($If]^a$gd~$d(($If]^a$gd~d$If]^gd5*%,%.%8%:%<%>%R%T%V%`%b%d%f%z%|%~%%%%%%%%%%%%%%%%%%%%۽۱۽۱۽۱u۽۱a۽۱&jRthhm5U^JaJ&jshhm5U^JaJ&jjshhm5U^JaJ&jrhhm5U^JaJhhm5^JaJhhm5+jhhm5U^JaJmHnHu jhhm5U^JaJ&jrhhm5U^JaJ#%%%&&&&&&&(&*&8&:&N&P&R&\&^&b&d&x&z&|&&&&&&&&&&&&۽۱۱۱۱۱u۽۱a۽Z hh0N&jvhhm5U^JaJ&j"vhhm5U^JaJ&juhhm5U^JaJ&j:uhhm5U^JaJhhm5^JaJhhm5+jhhm5U^JaJmHnHu jhhm5U^JaJ&jthhm5U^JaJ"`&b&&&&4'\'''''$(L(t(((($d(($If]^a$gd~$d(($If]^a$gd~d($If]^gd5Ffx$d(($If]^a$gd~&&&&&&&&&&&&&' ' ''"'$'&'0'2'4'6'J'L'N'X'Z'\'^'r'藆zfPzz+jhhm5U^JaJmHnHu&jb}hhm5U^JaJhhm5^JaJ jhhm5U^JaJhi.hm^JaJ j|h.^5U^JaJ j|h.^5U^JaJ%jh.^5U^JaJmHnHu j$|h.^5U^JaJjh.^5U^JaJh.^5^JaJr't'v''''''''''''''''''''''''''((( ("($(&(:(۹۹۹۹۹۹}۹۹i۹۹&jhhm5U^JaJ&j2hhm5U^JaJ&j~hhm5U^JaJ&jJ~hhm5U^JaJhhm5^JaJ+jhhm5U^JaJmHnHu jhhm5U^JaJ&j}hhm5U^JaJ#:(<(>(H(J(L(N(b(d(f(p(r(t(v(((((((((((((((((((((()۹۹۹۹۹۹}۹۹i۹۹&jhhm5U^JaJ&jvhhm5U^JaJ&jhhm5U^JaJ&jhhm5U^JaJhhm5^JaJ+jhhm5U^JaJmHnHu jhhm5U^JaJ&jhhm5U^JaJ#)))))))*),).)8):)<)>)R)T)V)`)b)d)f)|)~)))))))))۹۹۹۹۹yujy\yu۹jhmUmHnHuj׈hmUhmjhmUh6hmCJ hh0N&jFhhm5U^JaJ&j҂hhm5U^JaJhhm5^JaJ+jhhm5U^JaJmHnHu jhhm5U^JaJ&j^hhm5U^JaJ()<)d)f)|))) *'*G*a*****d($Ifgd~d(($If]^gd5d$If]^gd5Ff}$d(($If]^a$gd~^d(($If]^^gd~)))))))))) * *****'*(*6*7*8*9*G*H*V*W*X*Y*a*b*p*q*r*s****ijĢđĀo jhm5U^JaJ jhm5U^JaJ jhm5U^JaJ j5hm5U^JaJ jhm5U^JaJhhm5^JaJ jhhm5U^JaJjhm5U^JaJ jMhm5U^JaJ$************************++++++ +!+"+#+1+2+@+ijĢđĀo jIhm5U^JaJ jՍhm5U^JaJ jahm5U^JaJ jhm5U^JaJ jyhm5U^JaJhhm5^JaJ jhhm5U^JaJjhm5U^JaJ jhm5U^JaJ$**+1+L+l+m+w+,,,",*,0,8,>,F,$d(($Ifa$gd~$ d(($Ifa$gd~d(($If]^gd5d$If]^gd5FfƐd($Ifgd~@+A+B+C+L+M+[+\+]+^+l+m+w+x+++, , ,,,,,, ,",(,*,.,0,6,8,<,>,D,F,J,L,R,T,ijĬᖅrddddddddddhhm5>*^JaJ%jhm5U^JaJmHnHu jhm5U^JaJhm5^JaJh6hmCJ ^JaJ hhm j1hm5U^JaJhhm5^JaJ jhhm5U^JaJjhm5U^JaJ jhm5U^JaJ'F,L,T,Z,b,h,p,r,t,,,,-nn$d(($If]^a$gd~$d(($If]^a$gd~d$If]^gd5Ffd(($If^gd~$d(($Ifa$gd~$ d(($Ifa$gd~ T,f,h,n,p,r,t,v,,,,,,,,,,,,,,,,,,,,,,-------o[&jЙhhm5U^JaJ&j\hhm5U^JaJ&jhhm5U^JaJ+jhhm5U^JaJmHnHu&jthhm5U^JaJ jhhm5U^JaJh6hmCJ ^JaJ hh0Nhhm5^JaJhhm5>*^JaJ#-*-,-.-8-:-<->-R-T-V-`-b-d-f-z-|-~--------------------θΰθΰθΰtθΰ`θΰ&jhhm5U^JaJ&jhhm5U^JaJ&j,hhm5U^JaJ&jhhm5U^JaJhhm5+jhhm5U^JaJmHnHu jhhm5U^JaJ&jDhhm5U^JaJhhm5^JaJ$-<-d----,8`b4yd($If]^gd5Ff^d(($If]^^gd~$d(($If]^a$gd~$d(($If]^a$gd~$d(($If]^a$gd~---.(*8:NPR\^bdxz|ۻۯۯۯۯۯsۻۯ_ۻ&jXhhm5U^JaJ&jhhm5U^JaJ&jphhm5U^JaJ&jhhm5U^JaJhhm5^JaJhhm5U+jhhm5U^JaJmHnHu jhhm5U^JaJ&jhhm5U^JaJ" FORMTEXT        FORMTEXT        FORMTEXT       FORMTEXT      DOB: FORMTEXT      / FORMTEXT      / FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      First Name  FORMTEXT       FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health checkLast Name  FORMTEXT      INOUTINOUTINOUTINOUTINOUTINOUTINOUT FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT        FORMTEXT       FORMTEXT      DOB: FORMTEXT      / FORMTEXT      / FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      First Name  FORMTEXT       FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health checkLast Name  FORMTEXT      INOUTINOUTINOUTINOUTINOUTINOUTINOUT FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT        FORMTEXT       FORMTEXT      DOB: FORMTEXT      / FORMTEXT      / FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      First Name  FORMTEXT       FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health check FORMCHECKBOX  Absent  FORMCHECKBOX  Health checkLast Name  FORMTEXT      INOUTINOUTINOUTINOUTINOUTINOUTINOUT FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT        FORMTEXT       FORMTEXT      DOB: FORMTEXT      / FORMTEXT      / FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT           ҸԸָ "$&0246JLNXs_I+jhhm5U^JaJmHnHu&j$hhm5U^JaJhhm5^JaJ jhhm5U^JaJhhm5^JaJ jh.^5U^JaJ jPh.^5U^JaJ%jh.^5U^JaJmHnHu jh.^5U^JaJjh.^5U^JaJh.^5^JaJ hh0NXZ\^rtv¹ĹƹйҹԹֹ "$&:}i&jhhhm5U^JaJ&jhhm5U^JaJ&jhhm5U^JaJ&j hhm5U^JaJ+jhhm5U^JaJmHnHu&jhhm5U^JaJhhm5^JaJ jhhm5U^JaJ'4\Թ$Ltĺ<dfFf?^d(($If]^^gd~$d(($If]^a$gd~$d(($If]^a$gd~$d(($If]^a$gd~:<>HJLNbdfprtvºĺƺںܺ޺۹۹۹۹۹۹}۹۹i۹۹&jhhm5U^JaJ&j8hhm5U^JaJ&jĨhhm5U^JaJ&jPhhm5U^JaJhhm5^JaJ+jhhm5U^JaJmHnHu jhhm5U^JaJ&jܧhhm5U^JaJ#*,.8:<>RTV`bdf|~»۹۹۹۹۹yujy\yu۹jhmUmHnHujhmUhmjhmUh yhmCJ hh0N&jhhm5U^JaJ&jhhm5U^JaJhhm5^JaJ+jhhm5U^JaJmHnHu jhhm5U^JaJ&j hhm5U^JaJf|ػN¼8x"bؾھd$If]^gd5Ffd($IfgdfAgd(($If]^gd5d$If]^gd5»ĻƻȻػڻ68:<NPlnpr¼ļ ijĢđĀo jShm5U^JaJ j߲hm5U^JaJ jkhm5U^JaJ jhm5U^JaJ jhm5U^JaJhhm5^JaJ jhhm5U^JaJjhm5U^JaJ jhm5U^JaJ$ "$&8:VXZ\xzʽ̽νн "$@BDFbdijĢđĀo j hm5U^JaJ jhm5U^JaJ j#hm5U^JaJ jhm5U^JaJ j;hm5U^JaJhhm5^JaJ jhhm5U^JaJjhm5U^JaJ jdzhm5U^JaJ$ؾھ"$(*0268>@DFLijĬ{hZZZZZZZZhhm5>*^JaJ%jhm5U^JaJmHnHu jhm5U^JaJhm5^JaJhmCJ ^JaJh yhmCJ ^JaJ hhm jhm5U^JaJhhm5^JaJ jhhm5U^JaJjhm5U^JaJ jhm5U^JaJ#$*28@FNT\bjpxzFfټd(($If^gdfAg$d(($Ifa$gdfAg$ d(($Ifa$gdfAgdL(($If]^gd5LNRTZ\npvxz|~ȿʿ̿ο nZ&jhhm5U^JaJ&jhhm5U^JaJ&jhhm5U^JaJ+jhhm5U^JaJmHnHu&j6hhm5U^JaJ jhhm5U^JaJh yhmCJ ^JaJ hh0Nhhm5>*^JaJhhm5^JaJ#z|̿Dl 4@h{^d(($If]^^gdfAg$d(($If]^a$gdfAg$d(($If]^a$gdfAg$d(($If]^a$gdfAg$d$If]^a$gd5 246@BDFZ\^hjln͹͉͝ua&jhhm5U^JaJ&jbhhm5U^JaJ&jhhm5U^JaJ&jzhhm5U^JaJhhm5&jhhm5U^JaJhhm5^JaJ+jhhm5U^JaJmHnHu jhhm5U^JaJ& "$&02@BVXZdfjlڜڈt`&jhhm5U^JaJ&jhhm5U^JaJ&j2hhm5U^JaJ&jhhm5U^JaJ+jhhm5U^JaJmHnHu&jJhhm5U^JaJhhm5^JaJ jhhm5U^JaJhhm5$hj<d,T|$d(($If]^a$gdfAg$d(($If]^a$gdfAgd($If]^gd5FfK$d(($If]^a$gdfAg*,.8:<>RTV`s_I+jhhm5U^JaJmHnHu&jhhm5U^JaJhhm5^JaJ jhhm5U^JaJhhm5^JaJ j|h.^5U^JaJ jh.^5U^JaJ%jh.^5U^JaJmHnHu jh.^5U^JaJjh.^5U^JaJh.^5^JaJ hh0N`bdfz|~(*,.B}i&j*hhm5U^JaJ&jhhm5U^JaJ&jBhhm5U^JaJ&jhhm5U^JaJ+jhhm5U^JaJmHnHu&jZhhm5U^JaJhhm5^JaJ jhhm5U^JaJ'BDFPRTVjlnxz|~ ۹۹۹۹۹۹}۹۹i۹۹&jnhhm5U^JaJ&jhhm5U^JaJ&jhhm5U^JaJ&jhhm5U^JaJhhm5^JaJ+jhhm5U^JaJmHnHu jhhm5U^JaJ&jhhm5U^JaJ# 246@BDFZ\^hjln۹۹۹۹۹yujy\yu۹jhmUmHnHuj[hmUhmjhmUh yhmCJ hh0N&jhhm5U^JaJ&jVhhm5U^JaJhhm5^JaJ+jhhm5U^JaJmHnHu jhhm5U^JaJ&jhhm5U^JaJDln V @d($IfgdfAgd(($If]^gd5d$If]^gd5Ff$d(($If]^a$gdfAg^d(($If]^^gdfAg ">@BDVXtvxz (ijĢđĀo jhm5U^JaJ jhm5U^JaJ j-hm5U^JaJ jhm5U^JaJ jEhm5U^JaJhhm5^JaJ jhhm5U^JaJjhm5U^JaJ jhm5U^JaJ$(*,.@B^`bd*,HJLNjlijĢđĀo jhm5U^JaJ jYhm5U^JaJ jhm5U^JaJ jqhm5U^JaJ jhm5U^JaJhhm5^JaJ jhhm5U^JaJjhm5U^JaJ jhm5U^JaJ$*j$,2:@HNV$d(($Ifa$gdfAg$ d(($Ifa$gdfAgdL(($If]^gd5d$If]^gd5FfJd($IfgdfAg "$*,028:>@FHLNTijĬ{hZZZZZZZZhhm5>*^JaJ%jhm5U^JaJmHnHu jhhm5U^JaJhm5^JaJhmCJ ^JaJh yhmCJ ^JaJ hhm jhm5U^JaJhhm5^JaJ jhhm5U^JaJjhm5U^JaJ jAhm5U^JaJ#TVZ\bdvx~nZ&jThhm5U^JaJ&jhhm5U^JaJ&jlhhm5U^JaJ+jhhm5U^JaJmHnHu&jhhm5U^JaJ jhhm5U^JaJh yhmCJ ^JaJ hh0Nhhm5>*^JaJhhm5^JaJ#V\djrx$kk$d(($If]^a$gdfAg$d(($If]^a$gdfAg$d$If]^a$gd5Ffd(($If^gdfAg$d(($Ifa$gdfAg$ d(($Ifa$gdfAg  "$&:<>HJLNbdfprtv͹͉͝ua&jhhm5U^JaJ&j$hhm5U^JaJ&jhhm5U^JaJ&j<hhm5U^JaJhhm5&jhhm5U^JaJhhm5^JaJ+jhhm5U^JaJmHnHu jhhm5U^JaJ&$Lt<HprD{d$If]^gd5Ff ^d(($If]^^gdfAg$d(($If]^a$gdfAg$d(($If]^a$gdfAg$d(($If]^a$gdfAg*,.8:HJ^`blnrtڜڈt`&jhhm5U^JaJ&jhhhm5U^JaJ&jhhm5U^JaJ&jhhm5U^JaJ+jhhm5U^JaJmHnHu&j hhm5U^JaJhhm5^JaJ jhhm5U^JaJhhm5$ 246@BDFZ\^hs_I+jhhm5U^JaJmHnHu&jhhm5U^JaJhhm5^JaJ jhhm5U^JaJhhm5^JaJ j>h.^5U^JaJ jh.^5U^JaJ%jh.^5U^JaJmHnHu jjh.^5U^JaJjh.^5U^JaJh.^5^JaJ hh0Nhjln "$&0246J}i&jhhm5U^JaJ&jxhhm5U^JaJ&jhhm5U^JaJ&jhhm5U^JaJ+jhhm5U^JaJmHnHu&jhhm5U^JaJhhm5^JaJ jhhm5U^JaJ'Dl 4\$LtvFf^d(($If]^^gdfAg$d(($If]^a$gdfAg$d(($If]^a$gdfAg$d(($If]^a$gdfAgJLNXZ\^rtv۹۹۹۹۹۹}۹۹i۹۹&j0hhm5U^JaJ&jhhm5U^JaJ&jHhhm5U^JaJ&jhhm5U^JaJhhm5^JaJ+jhhm5U^JaJmHnHu jhhm5U^JaJ&j`hhm5U^JaJ# "$&:<>HJLNbdfprtv۹۹۹۹۹yujy\yuK jhh.^5U^JaJjh.^UmHnHujh.^Uh.^jh.^Uh yh.^CJ hh0N&jhhm5U^JaJ&jhhm5U^JaJhhm5^JaJ+jhhm5U^JaJmHnHu jhhm5U^JaJ&jhhm5U^JaJv(^H2r&d$If]^gd5Ff d($IfgdfAgd(($If]^gd5d$If]^gd5 (*FHJL^`|~0n jh.^5U^JaJ jch.^5U^JaJ jh.^5U^JaJ j{h.^5U^JaJ jh.^5U^JaJ jhh.^5U^JaJjh.^5U^JaJ jh.^5U^JaJhh.^5^JaJ%0246HJfhjl 24PRTVrtijĢđĀo jh.^5U^JaJ jh.^5U^JaJ jh.^5U^JaJ j3h.^5U^JaJ jh.^5U^JaJhh.^5^JaJ jhh.^5U^JaJjh.^5U^JaJ jKh.^5U^JaJ$"$&*,248:@BFHNPTV\ijĬ{hZZZZZZZZhh.^5>*^JaJ%jh.^5U^JaJmHnHu j* h.^5U^JaJh.^5^JaJh.^CJ ^JaJh yh.^CJ ^JaJ hh.^ jwh.^5U^JaJhh.^5^JaJ jhh.^5U^JaJjh.^5U^JaJ jh.^5U^JaJ#&,4:BHPV^dlrzd$If]^gd5Ff] d(($If^gdfAg$d(($Ifa$gdfAg$ d(($Ifa$gdfAg\^bdjl~nZ&jhh.^5U^JaJ&jhh.^5U^JaJ&j.hh.^5U^JaJ+jhh.^5U^JaJmHnHu&jhh.^5U^JaJ jhh.^5U^JaJh yh.^CJ ^JaJ hh0Nhh.^5>*^JaJhh.^5^JaJ#,T|DPxz^d(($If]^^gdfAg$d(($If]^a$gdfAg$d(($If]^a$gdfAg$d(($If]^a$gdfAg(*,.BDFPRTVjlnxz|~͹͉͝ua&jZhh.^5U^JaJ&jhh.^5U^JaJ&jrhh.^5U^JaJ&jhh.^5U^JaJhh.^5&jhh.^5U^JaJhh.^5^JaJ+jhh.^5U^JaJmHnHu jhh.^5U^JaJ& 246@BPRfhjtvz|ڜڈt`&jhh.^5U^JaJ&j*hh.^5U^JaJ&jhh.^5U^JaJ&jBhh.^5U^JaJ+jhh.^5U^JaJmHnHu&jhh.^5U^JaJhh.^5^JaJ jhh.^5U^JaJhh.^5$Lt<d,y^d(($If]^^gdfAg$d(($If]^a$gdfAg$d(($If]^a$gdfAg$d(($If]^a$gdfAgd($If]^gd5Ff "$&:<>HJLNbdfps_I+jhh.^5U^JaJmHnHu&jjhh.^5U^JaJhh.^5^JaJ jhh.^5U^JaJhh.^5^JaJ jh.^5U^JaJ jh.^5U^JaJ%jh.^5U^JaJmHnHu j,h.^5U^JaJjh.^5U^JaJh.^5^JaJ hh0Nprtv*,.8:<>R}i&jhh.^5U^JaJ&j:hh.^5U^JaJ&jhh.^5U^JaJ&jRhh.^5U^JaJ+jhh.^5U^JaJmHnHu&jhh.^5U^JaJhh.^5^JaJ jhh.^5U^JaJ'RTV`bdfz|~۹۹۹۹۹۹}۹۹i۹۹&j hh.^5U^JaJ&j~ hh.^5U^JaJ&j hh.^5U^JaJ&jhh.^5U^JaJhh.^5^JaJ+jhh.^5U^JaJmHnHu jhh.^5U^JaJ&j"hh.^5U^JaJ#(*,.BDFPRTVjlnxz|~۹۹۹۹۹|tptptptp|h jh UhhM;CJ^JaJ hh0N&jN"hh.^5U^JaJ&j!hh.^5U^JaJhh.^5^JaJ+jhh.^5U^JaJmHnHu jhh.^5U^JaJ&jf!hh.^5U^JaJ,T|~ dgdL \:gd mpFfw$$d(($If]^a$gdfAg< 0&P1h0:pQ= /!"#h$Z% tDText3tDText3tDText3$$If !vh#v#v#v#v#v(:V l4 t6+,55555(/ a p2yt0NtDText1tDText2tDText3$$If !vh#v#v#v#v#v#vE#v:V l4 t6+555555E5/ / / a pFyt0NjDvDText21vDText22vDText21vDText21vDText21vDText21vDText21vDText21vDText21vDText21vDText21vDText21vDText21vDText21vDText21vDText21vDText21vDText21vDText21vDText21$$If!vh#vG#vY#vj#vt#v#vs#vj:V lm t0v5g5m5s5v5z5v5s/  ap<yt0NkdR$$Iflmִ4k$+]3:g g m s v z v s  t0v    44 lap<yt0NvDText27tDeCheck7tDeCheck8tDeCheck7tDeCheck8tDeCheck7tDeCheck8tDeCheck7tDeCheck8tDeCheck7tDeCheck8tDeCheck7tDeCheck8tDeCheck7tDeCheck8$$If!vh#vG#vY#vj#vt#v#vs#vj:V l t0v5g5m5s5v5z5v5s/  ap<yt0Nkd_$$Iflִ4k$+]3:g g m s v z v s  t0v    44 lap<yt0NvDText27$$If!vh#vG#v#v#v#v#v#v#v#v #v #v #v #v #v #v:V l4 t0v+5g51565:535=565:5 <5 55 E5 ,5 J5 D5/apnyt0N[kd$$Ifl4N 4M k$(+v/]327:`g16:3=6:<5E,JD/ t0v<<<<44 lapnyt0NtDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7$$If!vh#vG#v#v#v#v#v#v#v#v #v #v #v #v #v #v:V l4 t0v+5g51565:535=565:5 <5 55 E5 ,5 J5 D5/apnyt0N[kd'$$Ifl4N 4M k$(+v/]327: g16:3=6:<5E,JD/ t0v<<<<44 lapnyt0NjDjDjDtDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7$$If!vh#vG#v#v#v#v#v#v#v#v #v #v #v #v #v #v:V l t0v5g51565:535=565:5 <5 55 E5 ,5 J5 D5//  apnyt0NXkd64$$IflN 4M k$(+v/]327:g 1 6 : 3 = 6 : < 5 E , J D /  t0v<<<<44 lapnyt0NvDText29tDeCheck7tDeCheck8tDeCheck7tDeCheck8tDeCheck7tDeCheck8tDeCheck7tDeCheck8tDeCheck7tDeCheck8tDeCheck7tDeCheck8tDeCheck7tDeCheck8$$If!vh#vG#vY#vj#vt#v#vs#vj:V l t0v5g5m5s5v5z5v5s/  ap<yt0Nkd!@$$Iflִ4k$+]3:g g m s v z v s  t0v    44 lap<yt0NvDText29$$If!vh#vG#v#v#v#v#v#v#v#v #v #v #v #v #v z#v:V l4 t0v+5g51565:535=565:5 <5 55 E5 ,5 J5 &5Mapnyt0N[kdC$$Ifl4N 4M k$(+v/]36:`g16:3=6:<5E,J&M t0v<<<<44 lapnyt0NtDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7$$If!vh#vG#v#v#v#v#v#v#v#v #v #v #v #v #v z#v:V l4 t0v+5g51565:535=565:5 <5 55 E5 ,5 J5 &5Mapnyt0N[kdHO$$Ifl4N 4M k$(+v/]36: g16:3=6:<5E,J&M t0v<<<<44 lapnyt0NjDjDjDtDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7$$If!vh#vG#v#v#v#v#v#v#v#v #v #v #v #v #v z#v:V l t0v5g51565:535=565:5 <5 55 E5 ,5 J5 &5M/  apnyt0NXkd[$$IflN 4M k$(+v/]36:g 1 6 : 3 = 6 : < 5 E , J & M  t0v<<<<44 lapnyt0NvDText30tDeCheck7tDeCheck8tDeCheck7tDeCheck8tDeCheck7tDeCheck8tDeCheck7tDeCheck8tDeCheck7tDeCheck8tDeCheck7tDeCheck8tDeCheck7tDeCheck8$$If!vh#vG#vY#vj#vt#v#vs#vj:V l t0v5g5m5s5v5z5v5s/  ap<yt0Nkdg$$Iflִ4k$+]3:g g m s v z v s  t0v    44 lap<yt0NvDText31$$If!vh#vG#v#v#v#v#v#v#v#v #v #v #v #v #v z#v:V l4 t0v+5g51565:535=565:5 <5 55 E5 ,5 J5 &5Mapnyt0N[kdk$$Ifl4N 4M k$(+v/]36:`g16:3=6:<5E,J&M t0v<<<<44 lapnyt0NtDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7$$If!vh#vG#v#v#v#v#v#v#v#v #v #v #v #v #v z#v:V l4 t0v+5g51565:535=565:5 <5 55 E5 ,5 J5 &5Mapnyt0N[kd w$$Ifl4N 4M k$(+v/]36: g16:3=6:<5E,J&M t0v<<<<44 lapnyt0NjDjDjDtDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7$$If!vh#vG#v#v#v#v#v#v#v#v #v #v #v #v #v z#v:V l t0v5g51565:535=565:5 <5 55 E5 ,5 J5 &5M/  apnyt0NXkd$$IflN 4M k$(+v/]36:g 1 6 : 3 = 6 : < 5 E , J & M  t0v<<<<44 lapnyt0NvDText32tDeCheck7tDeCheck8tDeCheck7tDeCheck8tDeCheck7tDeCheck8tDeCheck7tDeCheck8tDeCheck7tDeCheck8tDeCheck7tDeCheck8tDeCheck7tDeCheck8$$If!vh#vG#vY#vj#vt#v#vs#vj:V l t0v5g5m5s5v5z5v5s/  ap<yt0Nkd$$Iflִ4k$+]3:g g m s v z v s  t0v    44 lap<yt0NvDText33$$If!vh#vG#v#v#v#v#v#v#v#v #v #v #v #v #v z#v:V l4 t0v+5g51565:535=565:5 <5 55 E5 ,5 J5 &5Mapnyt0N[kdZ$$Ifl4N 4M k$(+v/]36:`g16:3=6:<5E,J&M t0v<<<<44 lapnyt0NtDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7$$If!vh#vG#v#v#v#v#v#v#v#v #v #v #v #v #v z#v:V l4 t0v+5g51565:535=565:5 <5 55 E5 ,5 J5 &5Mapnyt0N[kd̞$$Ifl4N 4M k$(+v/]36: g16:3=6:<5E,J&M t0v<<<<44 lapnyt0NjDjDjDtDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7$$If!vh#vG#v#v#v#v#v#v#v#v #v #v #v #v #v z#v:V l t0v5g51565:535=565:5 <5 55 E5 ,5 J5 &5M/  apnyt0NXkd|$$IflN 4M k$(+v/]36:g 1 6 : 3 = 6 : < 5 E , J & M  t0v<<<<44 lapnyt0NvDText35tDeCheck7tDeCheck8tDeCheck7tDeCheck8tDeCheck7tDeCheck8tDeCheck7tDeCheck8tDeCheck7tDeCheck8tDeCheck7tDeCheck8tDeCheck7tDeCheck8$$If!vh#vG#vY#vj#vt#v#vs#vj:V l t0v5g5m5s5v5z5v5s/  ap<yt0Nkdg$$Iflִ4k$+]3:g g m s v z v s  t0v    44 lap<yt0NvDText34$$If!vh#vG#v#v#v#v#v#v#v#v #v #v #v #v #v z#v:V l4 t0v+5g51565:535=565:5 <5 55 E5 ,5 J5 &5Mapnyt0N[kd$$Ifl4N 4M k$(+v/]36:`g16:3=6:<5E,J&M t0v<<<<44 lapnyt0NtDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7$$If!vh#vG#v#v#v#v#v#v#v#v #v #v #v #v #v z#v:V l4 t0v+5g51565:535=565:5 <5 55 E5 ,5 J5 &5Mapnyt0N[kd$$Ifl4N 4M k$(+v/]36: g16:3=6:<5E,J&M t0v<<<<44 lapnyt0NjDjDjDtDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7$$If!vh#vG#v#v#v#v#v#v#v#v #v #v #v #v #v z#v:V l t0v5g51565:535=565:5 <5 55 E5 ,5 J5 &5M/  apnyt0NXkd>$$IflN 4M k$(+v/]36:g 1 6 : 3 = 6 : < 5 E , J & M  t0v<<<<44 lapnyt0NvDText36tDeCheck7tDeCheck8tDeCheck7tDeCheck8tDeCheck7tDeCheck8tDeCheck7tDeCheck8tDeCheck7tDeCheck8tDeCheck7tDeCheck8tDeCheck7tDeCheck8$$If!vh#vG#vY#vj#vt#v#vs#vj:V l t0v5g5m5s5v5z5v5s/  ap<yt0Nkd)$$Iflִ4k$+]3:g g m s v z v s  t0v    44 lap<yt0NvDText37$$If!vh#vG#v#v#v#v#v#v#v#v #v #v #v #v #v z#v:V l4 t0v+5g51565:535=565:5 <5 55 E5 ,5 J5 &5Mapnyt0N[kd$$Ifl4N 4M k$(+v/]36:`g16:3=6:<5E,J&M t0v<<<<44 lapnyt0NtDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7$$If!vh#vG#v#v#v#v#v#v#v#v #v #v #v #v #v z#v:V l4 t0v+5g51565:535=565:5 <5 55 E5 ,5 J5 &5Mapnyt0N[kdP$$Ifl4N 4M k$(+v/]36: g16:3=6:<5E,J&M t0v<<<<44 lapnyt0NjDjDjDtDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7$$If!vh#vG#v#v#v#v#v#v#v#v #v #v #v #v #v z#v:V l t0v5g51565:535=565:5 <5 55 E5 ,5 J5 &5M/  apnyt0NXkd$$IflN 4M k$(+v/]36:g 1 6 : 3 = 6 : < 5 E , J & M  t0v<<<<44 lapnyt0NvDText39tDeCheck7tDeCheck8tDeCheck7tDeCheck8tDeCheck7tDeCheck8tDeCheck7tDeCheck8tDeCheck7tDeCheck8tDeCheck7tDeCheck8tDeCheck7tDeCheck8$$If!vh#vG#vY#vj#vt#v#vs#vj:V l t0v5g5m5s5v5z5v5s/  ap<yt0Nkd$$Iflִ4k$+]3:g g m s v z v s  t0v    44 lap<yt0NvDText38$$If!vh#vG#v#v#v#v#v#v#v#v #v #v #v #v #v z#v:V l4 t0v+5g51565:535=565:5 <5 55 E5 ,5 J5 &5Mapnyt0N[kd $$Ifl4N 4M k$(+v/]36:`g16:3=6:<5E,J&M t0v<<<<44 lapnyt0NtDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7$$If!vh#vG#v#v#v#v#v#v#v#v #v #v #v #v #v z#v:V l4 t0v+5g51565:535=565:5 <5 55 E5 ,5 J5 &5Mapnyt0N[kd$$Ifl4N 4M k$(+v/]36: g16:3=6:<5E,J&M t0v<<<<44 lapnyt0NjDjDjDtDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7tDText7$$If!vh#vG#v#v#v#v#v#v#v#v #v #v #v #v #v z#v:V l t0v5g51565:535=565:5 <5 55 E5 ,5 J5 &5Mapnyt0NXkd"$$IflN 4M k$(+v/]36:g16:3=6:<5E,J&M t0v<<<<44 lapnyt0Nj 666666666vvvvvvvvv666666>6666666666666666666666666666666666666666666666666hH6666666666666666666666666666666666666666666666666666666666666666662 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~ OJPJQJ_HmH nH sH tH R`R i.Normal d CJOJQJ_HaJmH sH tH DA D Default Paragraph FontRi@R 0 Table Normal4 l4a (k ( 0No List jj L9 Table Grid7:V0R@R L90 Balloon Text dCJOJQJ^JaJNoN L90Balloon Text CharCJOJQJ^JaJ>@"> L0HeaderdH$.1. L0 Header Char> B> L0FooterdH$.Q. L0 Footer CharPK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭V$ !)O^rC$y@/yH*񄴽)޵߻UDb`}"qۋJחX^)I`nEp)liV[]1M<OP6r=zgbIguSebORD۫qu gZo~ٺlAplxpT0+[}`jzAV2Fi@qv֬5\|ʜ̭NleXdsjcs7f W+Ն7`g ȘJj|h(KD- dXiJ؇(x$( :;˹! I_TS 1?E??ZBΪmU/?~xY'y5g&΋/ɋ>GMGeD3Vq%'#q$8K)fw9:ĵ x}rxwr:\TZaG*y8IjbRc|XŻǿI u3KGnD1NIBs RuK>V.EL+M2#'fi ~V vl{u8zH *:(W☕ ~JTe\O*tHGHY}KNP*ݾ˦TѼ9/#A7qZ$*c?qUnwN%Oi4 =3N)cbJ uV4(Tn 7_?m-ٛ{UBwznʜ"Z xJZp; {/<P;,)''KQk5qpN8KGbe Sd̛\17 pa>SR! 3K4'+rzQ TTIIvt]Kc⫲K#v5+|D~O@%\w_nN[L9KqgVhn R!y+Un;*&/HrT >>\ t=.Tġ S; Z~!P9giCڧ!# B,;X=ۻ,I2UWV9$lk=Aj;{AP79|s*Y;̠[MCۿhf]o{oY=1kyVV5E8Vk+֜\80X4D)!!?*|fv u"xA@T_q64)kڬuV7 t '%;i9s9x,ڎ-45xd8?ǘd/Y|t &LILJ`& -Gt/PK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-![Content_Types].xmlPK-!֧6 0_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!0C)theme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK] $:   hZ> (6~8d<d ,!!"\#p$*%%&r':())*@+T,--X:» L `B (ThJ0\pR!"$%&()+-./1235679;=>?ABCEFGIKLNOPQSTVXY[lmoprstvxy{|}~ N P &tL\6h!x#r$`&(*F,-4fzhV$Dv&, #'*,048:<@DHJMRUWZnquwz{%v  ,24@FWcikw} %3?EGSY[gm{./>NOYijy 4@F{'-/;ACOU]ior~#)+7=?KQS_egsy{   # $ - = > M ] ^ h x y   ' ( 7 G H R b c r   & ( 4 : < H N P \ b d p v x    $ 0 6 8 D J L X ^ ` l r t   & ( 4 : < H N P \ b d p v '78GWXbrs"#=IO"$068DJLX^frx{   ,24@FHTZ\hnp|,-6FGVfgq 01@PQ[kl{(.0<BDPVXdjlx~ %,8>@LRT`fhtz|(.0<BDPVXdjlx~%&/?@O_`jz{*+EQW$*,8>@LRT`fnz  &(4:<HNP\bdpvx"$45>NO^noy(89HXYcst"$068DJLX^`lrt'-4@FHTZ\hnp|"$068DJLX^`lrt   - . 7 G H W g h r !!!"!2!3!M!Y!_!!!!!!!!!!!!!!!!!" " """ ","2"4"@"F"H"T"Z"\"h"n"v"""""""""""""""""""######(#.#0#<#B#D#P#V#X#d#j#l#x#~####################$ $$FFFFFFFFFFFFFFFFFFFFFFFFFFFFGTGTGTGTGTGTGTGTGTGTGTGTGTGTFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFGTGTGTGTGTGTGTGTGTGTGTGTGTGTFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFGTGTGTGTGTGTGTGTGTGTGTGTGTGTFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFGTGTGTGTGTGTGTGTGTGTGTGTGTGTFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFGTGTGTGTGTGTGTGTGTGTGTGTGTGTFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFGTGTGTGTGTGTGTGTGTGTGTGTGTGTFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFGTGTGTGTGTGTGTGTGTGTGTGTGTGTFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFT # @H 0(  0(  B S  ?Text1Text2Text3Text21Text22Text27Text29Text30Text31Text32Text33Text35Text34Text36Text37Text39Text38| > FN!$  PX#`!$$$$$$$$$$$$$$$$$$${&qqu  34GVjk~&2FGZ[nyz{./BCV]pr   ' ( ; < O P c d w x   _ x y #$78KL_fy{/0CDWXkl&'g+,?@STgn#$78KL_`st./oB!C!M!`!!!!!!!!!!!!!! " "" "3"4"G"H"["\"o"v"""""""""""""" $ $$0M?_h:OyOMvw: Y,tCIcrx% #my<Qc yu.^J='av<%K%R%0J+<,C,i.-u.ru.P0)G4x4D5R8V9ya9:Uh:p:^;LM=p=E>)?>?f@9 AJxBC[CeE iFKxy6Qf|oN`>I jrvsCs?~5 0Ea%s ?#*rEq|sksrn489U}.]Y$'8b{yu1L,%z`_](LR~*_$$@AAAA JJJJ$ $@4@ D@$&(T@,UnknownG*Ax Times New Roman5Symbol3. *Cx Arial7.@ Calibri5. .[`)TahomaA$BCambria Math"hIGIGaAaA*!hr0##NQX  $PR?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./013456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUWXYZ[\]_`abcdejRoot Entry F LlData '1Table2 FWordDocument>:SummaryInformation(VDocumentSummaryInformation8^CompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q