ĘÔ觡ŐčĘč§ÁŇ´éÇ 1

 

 

 

 

 

 

 

 

 

 

 

ľŃÇÍÂčҧ

 

ĄŇèѴˇÓŕÍĄĘŇäӢ͝ĂĐŕÁÔšşŘ¤¤ĹáĹĐťĂĐŕÁÔšźĹ§Ňš

ĘÓËĂŃşźŮ靯ԺѾԧҚˇŐčÍŇČѤÇŇÁĂŮé  ¤ÇŇÁŞÓšŇ­áĹĐťĂĐĘşĄŇĂłě੾ŇĐľŃÇ

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(ľŃÇÍÂčҧťĄáşşťĂĐŕÁÔšşŘ¤¤ĹáĹĐťĂĐŕÁÔšźĹ§Ňš)

 

 

 

ŕÍĄĘŇäӢ͝ĂĐŕÁÔšşŘ¤¤ĹáĹĐťĂĐŕÁÔšźĹ§Ňš

 

 

â´Â

 

šŇ……………………………………………..

ĘѧĄŃ´………………………………………………..

 

 

 

 

ŕÍĄĘŇäӢ͝ĂĐŕÁÔšşŘ¤¤ĹáĹĐťĂĐŕÁÔšźĹ§Ňšŕž×čÍáľč§ľŃé§ăËé´Óç

ľÓá˹觅…………………………………..

ĘÓËĂŃşźŮ靯ԺѾԧҚˇŐčÍŇČѤÇŇÁĂŮé  ¤ÇŇÁŞÓšŇ­áĹĐťĂĐĘşĄŇĂłě੾ŇĐľŃÇ

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

áşşťĂĐŕÁÔšşŘ¤¤ĹáĹĐťĂĐŕÁÔšźĹ§Ňš    

 

                   ŕž×čÍťĂĐĄÍşĄŇĂžÔ¨ŇóҤѴŕĹ×ÍĄŕž×čÍŕĹ×čÍš˘éŇĂŇŞĄŇĂžĹŕĂ×ÍšĘŇÁŃ­˘Öéšáľč§ľŃé§

           ăËé´ÓçľÓáËšč§ĂĐ´Ńş 4 ËĂ×Í ĂĐ´Ńş 5 ËĂ×Í 6  ĘÓËĂŃşľÓá˚觡Őč Ą.ž. ĄÓËš´ŕťçšľÓá˚觠   

                     ĂĐ´Ńş 1 - 3 ËĂ×Í 4 ËĂ×Í 5 ËĂ×Í 6  ËĂ×ÍľÓáËšč§ĂĐ´Ńş 2 - 4 ËĂ×Í 5 ËĂ×Í 6

         

 


                      ľÍšˇŐč 1   ˘éÍÁŮĹŕş×éͧľéš˘Í§źŮé˘ÍĂŃşĄŇĂťĂĐŕÁÔš                                                                                                                                                   

 


          1.  Ş×čÍźŮé˘ÍĂŃşĄŇĂťĂĐŕÁÔš…………………………………………………………………………………………………………………..  

2.  ÇزԥŇĂČÖĄÉ҅………………………………………………………………………………………………………………………………..

3.  ťŃ¨¨ŘşŃš´ÓçľÓá˹觅…………………………………..ĂĐ´Ńş……………………(ľÓáËšč§ŕޡŐ腅………………)

     §Ňš/˝čŇ……………………………………………….ĘӚѥ/ĄÍ§…………………………….ĄĂÁ…….………………………….

     ÍŃľĂŇŕ§Ôšŕ´×Íš˘Ń鹅……………………….şŇˇ    (ťŐ§şťĂĐÁŇł ž.ȅ……………………………………………..)

4.  ľÓá˚觡Őč˘ÍťĂĐŕÁÔš……………………………………….ĂĐ´Ńş……..(ľÓáËšč§ŕޡŐ腅………………………….)      

     §Ňš/˝čŇ……………………………………………….ĘӚѥ/ĄÍ§……………………………….ĄĂÁ………………………………

5.  ťĂĐÇŃľÔĄŇĂĂŃşĂŇŞĄŇĂ

 

       ÇŃš ŕ´×Íš ťŐ         ľÓá˚觠               ÍŃľĂŇŕ§Ôšŕ´×Íš              ĘѧĄŃ´

 

        ……………………      ……………………………          ……………………        …………………………  

        …………………..      ……………………………          ……………………        …………………………

        …………………..      ……………………………          ……………………        …………………………

        …………………..      ……………………………          ……………………        …………………………

        …………………..      ……………………………          ……………………        ………………….…….

        …………………..      ……………………………          ……………………        …………………………

 

 

6.  ËšéҡŐč¤ÇŇÁĂŃşźÔ´ŞÍş˘Í§ľÓáËšč§ăšťŃ¨¨ŘşŃš

          …………………………………………………………………………………………………………………………………………………..

………………………………………………………………………………………………………………………………………………………………..

…………………………………………………………………………………………………………………………………………………………………

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…………………………………………………………………………………………………………………………………………………………………

                  

 

 

 

 

                             - 2 -

 

 

         

                     

ľÍšˇŐč 1   ˘éÍÁŮĹŕş×éͧľéš˘Í§źŮé˘ÍĂŃşĄŇĂťĂĐŕÁÔš  (ľčÍ)                                                                                                                                                     

 

 

 


      7.  ËšéҡŐč¤ÇŇÁĂŃşźÔ´ŞÍş˘Í§ľÓá˚觡Őč¨Đ˘ÍťĂĐŕÁÔš

…………………………………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………………………….

……………………………………………………………………………………………………………………………………………………………………

 

 

 

 

 

 

                                   (ŧŞ×čÍ) ……………………………………………………  źŮé˘ÍĂŃşĄŇĂťĂĐŕÁÔš

                                               (………………………………………………..)

                                     ľÓá˹觅……………………………………………..             

                                        ÇŃšˇŐ腅……ŕ´×Íš……………………ž.ȅ…………                  

                                       

 

 

 

 

 

 

 

 

 

 

 

 

- 3 -

 

 


                      ľÍšˇŐč 2   ĄŇĂľĂǨĘÍş¤ŘłĘÁşŃľÔ˘Í§şŘ¤¤Ĺ (ĘÓËĂѺ˚čǧҚĄŇĂŕ¨éŇËšéҡŐč)                                                                                                                     

      1.  ¤ŘłĘÁşŃľÔľŇÁÁҾðҚĄÓËš´ľÓáËšč§

              o  ľĂ§      o äÁčľĂ§

      2.  ¤ŘłĘÁşŃľÔÍ×čš ć ľŇÁˇŐč Ą.ž.ĄÓËš´ŕžÔčÁŕľÔÁ

               2.1  ĂĐÂĐŕÇĹŇĄŇĂ´ÓçľÓá˚觡ŐčľÔ´ľčÍĄŃšăšĘҧҚ˘Í§ľÓá˚觡Őč¨Đáľč§ľŃé§

            ăšĂĐ´ŃşˇŐčľčÓĄÇčŇĂĐ´ŃşˇŐč˘ÍťĂĐŕÁÔš 1 ĂĐ´Ńş

              o ….…………………..ťŐ  

2.2  ĂĐÂĐŕÇĹŇĄŇĂ´ÓçľÓáËšč§ăšĘҧҚˇŐč¨Đáľč§ľŃé§ËĂ×ÍĘҧҚˇŐčŕĄŐčÂǢéͧ

            áĹĐŕĄ×éÍĄŮĹĄŃšľŇÁ¤ŘłÇزԢͧşŘ¤¤Ĺ áĹĐĂĐ´ŃşľÓá˚觡Őč¨Đáľč§ľŃé§

                          o…………….………..ťŐ     

     2.3  ÍŃľĂŇŕ§Ôšŕ´×Íš (ŕťĂŐÂşŕˇŐÂşľŇÁ˚ѧĘ×ÍĘӚѥ§Ňš Ą.ž. ˇŐč šĂ 0708.1/Ç 13                        

            ŧÇŃšˇŐč 15 ĄŃšÂŇš 2536)        

              o  ľĂ§      o äÁčľĂ§

3.  ťĂĐÇŃľÔăšĂŇŞĄŇĂ   

               o  ŕ¤ÂśŮĄĹ§âˇÉˇŇ§ÇԚѠ…………………………………….. ŕÁ×čÍ ………..………..

                            o ĄÓĹѧÍÂŮčăšĂĐËÇčҧśŮĄĘÍşĘÇšˇŇ§ÇԚѠ   

               o ĄÓĹѧÍÂŮčăšĂĐËÇčҧśŮĄĹ§âˇÉˇŇ§ÇԚѠ   

                            o äÁčŕ¤ÂśŮĄĹ§âˇÉˇŇ§ÇÔšŃÂáĹĐäÁčÍÂŮčăšĂĐËÇčҧśŮĄĘÍşĘÇšËĂ×͜٥ŧâˇÉˇŇ§ÇÔšŃÂ

     ĘĂŘťźĹĄŇĂľĂǨĘÍş

        źŮé˘ÍĂŃşĄŇĂťĂĐŕÁÔš o ÁդسĘÁşŃľÔľĂ§ľŇÁÁҾðҚĄÓËš´ľÓáËšč§ áĹФسĘÁşŃľÔÍ×čš ć     

                                    ľĂ§ľŇÁˇŐč Ą.ž. ĄÓËš´ŕžÔčÁŕľÔÁ

                      o ÁդسĘÁşŃľÔľĂ§ľŇÁÁҾðҚĄÓËš´ľÓáËšč§ áĹĐäÁčÁդسĘÁşŃľÔÍ×čš ć       

                ľĂ§ľŇÁˇŐč Ą.ž. ĄÓËš´ŕžÔčÁŕľÔÁ

                      o äÁčÁդسĘÁşŃľÔľĂ§ľŇÁÁҾðҚĄÓËš´ľÓáËšč§ áĹФسĘÁşŃľÔÍ×čš ć         

                                              ľĂ§ľŇÁˇŐč Ą.ž. ĄÓËš´ŕžÔčÁŕľÔÁ

                                        o Í×čš ć  ……...……………..………………………………………………………………………………….

                                                   (ŧŞ×čÍ)  ……………………………………………………………  

                                                              ( ………………………………………………………..)

                                                   ľÓá˚觠 ……………………………………………………………

                                                        ÇŃšˇŐ腅……ŕ´×Íš………………………ž.ȅ…………     

 

 

                  

                                                           - 4 -

 

 

 


                    ľÍšˇŐč 3   ĄŇĂťĂĐŕÁÔš¤ŘłĹŃĄÉłĐ੾Ňкؤ¤Ĺ  (ĘÓËĂŃşźŮéşŃ§¤ŃşşŃ­ŞŇ)

 

                                                                                             (¤ĐáššŕľçÁ 100 ¤Đášš)      

 

 Ą.  ĄŇĂťĂĐŕÁÔš˘Í§źŮéşŃ§¤ŃşşŃ­ŞŇĂĐ´ŃşËŃÇËšéҧҚ ËĂ×ÍËŃÇËšéŇ˝čŇ ËĂ×ÍŕˇŐÂşŕˇčŇ

     

                    

                          ĂŇÂĄŇĂťĂĐŕÁÔš                                      ¤ĐáššŕľçÁ    ¤ĐáššˇŐčä´éĂŃş

 

 

 


          1.  ¤ÇŇÁťĂОľÔ

                             ŕťçšĄŇĂžÔ¨ŇĂłŇÍŘťšÔĘŃÂáĹФÇŇÁťĂОľÔĘčÇšľŃÇ    25

               ľĹÍ´¨šĄŇĂťŻÔşŃľÔľŇÁšâºҠĂĐŕşŐÂş áşşáźš áĹĐ

               ˘éͺѧ¤Ńş˘Í§ĘčÇšĂŇŞĄŇĂšŃéš ć  ĄŇĂĂŃĄÉŇÇÔšŃ¢éŇĂŇŞĄŇèҥ

               ťĂĐÇŃľÔĘčÇšľŃÇ  ťĂĐÇŃľÔĄŇáӧҚ  áĹОľԥĂĂÁˇŐčťĂŇĄŻˇŇ§Í×čš

         

         

 

 

          2.  ¤ÇŇÁĂŃşźÔ´ŞÍşľčÍËšéҡŐč

                             ŕťçšĄŇĂžÔ¨ŇóҤÇŇÁľŃé§ă¨ăšĄŇáӧҚ              25

               ¤ÇŇÁÁŘč§ÁŃ蚡Őč¨ĐˇÓ§ŇšˇŐčä´éĂŃşÁÍşËÁŇÂăËéĘÓŕĂç¨ŕťçšźĹ´Ő

               ĄŇĂäÁčĹĐŕĹÂľčͧҚ  ĂÇÁśÖ§¤ÇŇÁŕľçÁă¨áĹФÇŇÁĄĹéҡŐč¨Đ

               ĂŃşźÔ´ľčÍźĹŕĘŐÂËŇ¡ŐčÍҨŕĄÔ´˘Öéš  äÁčťŃ´¤ÇŇÁĂŃşźÔ´ŞÍş§čŇ ć

               áĹФÇŇÁ¨Ăԧ㨡Őč¨ĐťĂŃşťĂاľŃÇŕͧăËé´Ő˘Öéš

 

 

 

 

          3.  ¤ÇŇÁÍŘľĘŇËĐ

                             ŕťçšĄŇĂžÔ¨ŇóҤÇŇÁÁŐÁҚР Í´ˇš  ŕÍŇă¨ăĘčăš            25

               ËšéҡŐčĄŇçҚ  ĄĂĐľ×ÍĂ×ÍĂéšăšĄŇĂťŻÔşŃľÔ§Ňš  â´ÂÍءÔČŕÇĹŇ

               ăËéĄŃşˇŇ§ĂŇŞĄŇĂ  äÁčŕŠ×čÍÂŞŇ  áĹĐÁŐ¤ÇŇÁ˘ÂŃšËÁŃčšŕžŐÂĂ

 

 

 

 

 

- 5 -

 

 

 

 


                    ľÍšˇŐč 3   ĄŇĂťĂĐŕÁÔš¤ŘłĹŃĄÉłĐ੾Ňкؤ¤Ĺ  (ĘÓËĂŃşźŮéşŃ§¤ŃşşŃ­ŞŇ)  (ľčÍ)

 

                    

                          ĂŇÂĄŇĂťĂĐŕÁÔš                                       ¤ĐáššŕľçÁ   ¤ĐáššˇŐčä´éĂŃş

 

 

 


          4.  ¤ÇŇÁĘŇÁŇÜ㚥ŇĂťŻÔşŃľÔ§ŇšĂčÇÁĄŃşŕž×čÍšĂčÇÁ§Ňš

               ÍÂčҧÁŐťĂĐĘÔˇ¸ÔŔŇž         

                             ŕťçšĄŇĂžÔ¨ŇóҤÇŇÁĘŇÁŇÜ㚥ŇáӧҚ                      25

               ĂčÇÁĄŃşźŮéÍ×čš  ÂÍÁĂŃşżŃ§¤ÇŇÁ¤Ô´ŕË皢ͧźŮéÍ×čš  áĹĐÂÍÁĂŃş

               ăš¤ÇŇÁĘŇÁŇĂś˘Í§źŮéĂčÇÁ§ŇšˇŘĄĂĐ´Ńş

         

 

 

         

 

                                      ¤ĐáššĂÇÁĘÓËĂŃş¤ŘłĹŃĄÉłĐ੾Ňкؤ¤Ĺ  …………………  ¤Đášš

 

                       ĘĂŘťźĹĄŇĂťĂĐŕÁÔš      o  źčŇšĄŇĂťĂĐŕÁÔš   

                o  äÁčźčŇšĄŇĂťĂĐŕÁÔš

 

 

 

                                                  ŧŞ×čÍźŮéťĂĐŕÁÔš  ……………………………………………………………  

                                                                     ( ………………………………………………………..)

                                                         ľÓá˚觠 ……………………………………………………………

                                                              ÇŃšˇŐč  ………………ŕ´×Íš…………………ž.Č.…………

 

 

 

 

 

 

- 6 -

 

 

 


                    ľÍšˇŐč 3   ĄŇĂťĂĐŕÁÔš¤ŘłĹŃĄÉłĐ੾Ňкؤ¤Ĺ  (ĘÓËĂŃşźŮéşŃ§¤ŃşşŃ­ŞŇ)  (ľčÍ)

 

 

                    

 

˘.  ĄŇĂťĂĐŕÁÔš˘Í§źŮéşŃ§¤ŃşşŃ­ŞŇĂĐ´ŃşĄÍ§  ËĂ×ÍŕˇŐÂşŕˇčŇ

 

               o    ŕËçš´éÇÂĄŃşĄŇĂťĂĐŕÁÔš˘éҧľéš

     o    ÁŐ¤ÇŇÁŕËçšáľĄľčҧ¨ŇĄĄŇĂťĂĐŕÁÔš˘éҧľéš  ´Ń§šŐé

 

1. ¤Đášš¤ÇŇÁťĂОľԠ ………………………..……………..  ¤Đášš

2. ¤Đášš¤ÇŇÁĂŃşźÔ´ŞÍşľčÍËšéҡŐč  ……………………..  ¤Đášš

3. ¤Đášš¤ÇŇÁÍŘľĘŇËĐ  …………………………………………  ¤Đášš

4. ¤Đášš¤ÇŇÁĘŇÁŇÜ㚥ŇĂťŻÔşŃľÔ§ŇšĂčÇÁĄŃşŕž×čÍšĂčÇÁ§Ňš      

                   ÍÂčҧÁŐťĂĐĘÔˇ¸ÔŔŇž  …………………………………………...  ¤Đášš

 

 

ĘĂŘťźĹĄŇĂťĂĐŕÁÔš      o  źčŇšĄŇĂťĂĐŕÁÔš   

o  äÁčźčŇšĄŇĂťĂĐŕÁÔš

 

                  

                                                  ŧŞ×čÍźŮéťĂĐŕÁÔš  ……………………………………………………………  

                                                                     ( ………………………………………………………..)

                                                         ľÓá˚觠 ……………………………………………………………

                                                              ÇŃšˇŐč  …………ŕ´×Íš…………………..ž.Č.……………

 

 

 

 

 

 

 

 

 

 

 

- 7 -

 

 

 


ľÍšˇŐč 4   áşşťĂĐŕÁÔšźĹ§Ňš  (ĘÓËĂŃşĄĂĂÁĄŇĂźŮéăËé¤ĐáššĄŇĂťĂĐŕÁÔš)

 

                                                                                                (¤ĐáššŕľçÁ 100 ¤Đášš)

                    

         

                               ľÓá˚觠 …………………………………………………………………………

                             Ş×čÍźŮé˘ÍĂŃşĄŇĂťĂĐŕÁÔš  ………………………………………………………………...

 

 

          ľÍš Ą.  ăËéźŮé˘ÍĂŃşĄŇĂťĂĐŕÁÔšáĘ´§ĂŇÂĹĐŕÍŐ´ĄŇĂťŻÔşŃľÔ§ŇšăšŞčǧ 2 ťŐ ˇŐčźčŇšÁŇ 

                      ä´éťŻÔşŃľÔ§ŇšÍĐäĂşéҧ  áĹĐăšáľčĹЧҚÁŐťĂÔÁŇłÁŇĄšéÍÂŕžŐ§ă´

 

 

  …….…………………………..¤Đášš

 

 

 

 

          ľÍš ˘.  ăËéźŮé˘ÍĂŃşĄŇĂťĂĐŕÁÔššÓźĹ§Ňš  ËĂ×ÍžĂóҟŧҚ  ŤÖ觾šŕͧŕťçšźŮéťŻÔşŃľÔ ËĂ×Íä´éĂčÇÁ

                      ťŻÔşŃľÔ§Ňš¨ĂÔ§  â´ÂăËéźŮéşŃ§¤ŃşşŃ­ŞŇŧŞ×čÍĂŃşĂͧ´éÇ  ľŇÁŕš×éÍËŇ  áĹШӚǚˇŐč

                      ¤łĐĄĂĂÁĄŇĂ´ÓŕšÔšĄŇĂŕĄŐčÂÇĄŃşĄŇäѴŕĹ×ÍĄŕž×čÍŕĹ×čÍš˘éŇĂŇŞĄŇĂžĹŕĂ×ÍšĘŇÁŃ­

                      ťĂĐŕÁÔšşŘ¤¤ĹáĹПŧҚĄÓËš´

                      

 

  …….…………………………..¤Đášš

 

 

 

                                                             ¤ĐáššĂÇÁ  …………………………  ¤Đášš

 

 

                                        ŧŞ×čÍźŮéťĂĐŕÁÔš………………………………………………….

                                                            (  …………………………………………..  )                

                                                  ľÓá˚觠 ………………………………………………

                                                  ÇŃšˇŐč  ………ŕ´×Íš…………………ž.Č.………..

 

 

 

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                                      (ŧŞ×čÍ)……………………………………………………źŮé˘ÍĂŃşĄŇĂťĂĐŕÁÔš

                                                                (….…………….…………………………..)

                                                    ľÓá˹觅………………………………………………

                                                          ÇŃšˇŐ腅……ŕ´×Íš…………….ž.ȅ..…

 

 

 

¤ÓĂŃşĂͧ˘Í§źŮéşŃ§¤ŃşşŃ­ŞŇ  (źŮéşŃ§¤ŃşşŃ­ŞŇˇŐč¤Çş¤ŘÁ´ŮáĹĄŇĂťŻÔşŃľÔ§Ňš)

 

ä´éľĂǨĘÍşźĹ§Ňš˘Í§……………………………………………………ˇŐčšÓŕĘšÍ㚾ͥ Ą.áĹéÇŕËçšÇčҜ٥ľéͧľĂ§

¤ÇŇÁ¨ĂÔ§ˇŘĄťĂĐĄŇĂ

                   ¤ÇŇÁŕËçšÍ×čš (śéŇÁŐ)……………………………………………………………………………………………………………………………….

……………………………………………………………………………………………………………………………………………………………………………………………..

……………………………………………………………………………………………………………………………………………………………………………………………..

 

 

 

 

                                  (ŧŞ×čÍ)……………………………………………………źŮéĂŃşĂͧźĹ§Ňš

                                                                 (….…………….…………………………..)

                                                    ľÓá˹觅………………………………………………

                                                          ÇŃšˇŐ腅……ŕ´×Íš…………….ž.ȅ..…

 

         

 

 

 

 

 

 

 

 

 

 

 

 

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ľÍš ˘
ŕĂ×čͧˇŐč 1

 

1.    Ş×č͟ŧҚ  ………………………………………………………………………………………………………………………………………………………………..

……………………………………………………………………………………………………………………………………………………………………………………

2.    Ş×čÍźŮé˘ÍĂŃşĄŇĂťĂĐŕÁÔš  …………………………………………………………………………………………………………………………………………….

2.1  Ş×čÍ (źŮéÁŐĘčÇšĂčÇÁ¨Ń´ˇÓźĹ§Ňš)…………………………………………………………………………………………………………………………

2.2  ä´éÁŐĘčÇš¨Ń´ˇÓźĹ§ŇšˇŐčŕĄŐčÂÇĄŃş (ĂĐşŘĹѥɳЧҚ)………………………………………………………………………………………..

…………………………………………………………………………………………………………………………………………………………………………….

2.3  ÁŐĘŃ´Ęčǚ㚥ŇèѴˇÓźĹ§Ňš¤Ô´ŕťçšĂéÍÂĹЅ……….………………………………………………………………………………………..

…………………………………………………………………………………………………………………………………………………………………………….

3.  ʜҚˇŐč´ÓŕšÔšĄŇĂ

     ……………………………………………………………………………………………………………………………………………………………………………………..

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     ……………………………………………………………………………………………………………………………………………………………………………………..

 

4.  ĂĐÂĐŕÇĹҡӧҚ

     ……………………………………………………………………………………………………………………………………………………………………………………..

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     ……………………………………………………………………………………………………………………………………………………………………………………..

5.  ťĂÔÁŇł§ŇšËĂ×ÍĹѥɳЧҚ㚤ÇŇÁĂŃşźÔ´ŞÍş

     ……………………………………………………………………………………………………………………………………………………………………………………..

     ………………………………………………………………………………………………………………………………………………………………………………………

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6.  ˘Ń难͚㚥ŇĂ´ÓŕšÔšĄŇĂ

     ……………………………………………………………………………………………………………………………………………………………………………………..

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7.  ĹѥɳОÔŕČɡŐčáĘ´§śÖ§¤ÇŇÁÂŘč§ÂŇĄ˘Í§§Ňš

     ……………………………………………………………………………………………………………………………………………………………………………………..

     ………………………………………………………………………………………………………………………………………………………………………………………

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8.  ĄŇÚӟŧҚäťăŞéťĂĐâÂŞšě

     ……………………………………………………………………………………………………………………………………………………………………………………..

     ………………………………………………………………………………………………………………………………………………………………………………………

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9.  źĹ§ŇšĄŇĂ´ÓŕšÔšĄŇĂ

     ……………………………………………………………………………………………………………………………………………………………………………………..

     ………………………………………………………………………………………………………………………………………………………………………………………

     ……………………………………………………………………………………………………………………………………………………………………………………..

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10.  ťŃ­ËŇáĹĐášÇˇŇ§áĄéä˘

     ……………………………………………………………………………………………………………………………………………………………………………………..

     ………………………………………………………………………………………………………………………………………………………………………………………

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       ………………………………………………………………………………………………………………………………………………………………………………………

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                                      (ŧŞ×čÍ)……………………………………………………źŮé˘ÍĂŃşĄŇĂťĂĐŕÁÔš

                                                                 (….…………….…………………………..)

                                                    ľÓá˹觅………………………………………………

                                                          ÇŃšˇŐ腅……ŕ´×Íš…………….ž.ȅ..…

 

         

 

 

 

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¤ÓĂŃşĂͧ˘Í§źŮéşŃ§¤ŃşşŃ­ŞŇ  (źŮéşŃ§¤ŃşşŃ­ŞŇˇŐč¤Çş¤ŘÁ´ŮáĹĄŇĂťŻÔşŃľÔ§Ňš)

 

ä´éľĂǨĘÍşźĹ§Ňš˘Í§…………………………………………ˇŐčšÓŕĘšÍ㚾͚ ˘.ŕĂ×čͧˇŐč 1 áĹéÇŕËçšÇčҜ٥ľéͧ

ľĂ§¤ÇŇÁ¨ĂÔ§ˇŘĄťĂĐĄŇĂ

                   ¤ÇŇÁŕËçšÍ×čš (śéŇÁŐ)……………………………………………………………………………………………………………………………….

……………………………………………………………………………………………………………………………………………………………………………………………..

……………………………………………………………………………………………………………………………………………………………………………………………..

……………………………………………………………………………………………………………………………………………………………………………………………..

……………………………………………………………………………………………………………………………………………………………………………………………..

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                                    (ŧŞ×čÍ)……………………………………………………źŮéĂŃşĂͧźĹ§Ňš

                                                                 (….…………….…………………………..)

                                                     ľÓá˹觅………………………………………………

                                                          ÇŃšˇŐ腅……ŕ´×Íš…………….ž.ȅ..…

 

         

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

¤Ó͸ԺŇÂĄŇèѴˇÓŕÍĄĘŇäӢ͝ĂĐŕÁÔšşŘ¤¤ĹáĹĐťĂĐŕÁÔšźĹ§Ňš

ĘÓËĂŃşźŮ靯ԺѾԧҚˇŐčÍŇČѤÇŇÁĂŮé ¤ÇŇÁŞÓšŇ­áĹĐťĂĐĘşĄŇĂłě੾ŇĐľŃÇ

 

1.      ľÍšˇŐč 1  ˘éÍÁŮĹŕş×éͧľéš˘Í§źŮé˘ÍĂŃşĄŇĂťĂĐŕÁÔš

-          ÇزԥŇĂČÖĄÉŇ  ăËéĂĐşŘÇزԡŐčä´éĂŃşˇŘĄÇزÔ

-          ťĂĐÇŃľÔĄŇĂĂŃşĂŇŞĄŇĂ  ăËéĂкؾŃé§áľčŕĂÔčÁĂŃşĂŇŞĄŇèšśÖ§ťŃ¨¨ŘşŃš áĘ´§ŕŠžŇСŐčä´éĂŃşáľč§ľŃé§

ăËé´ÓçľÓáËšč§ăšĂĐ´ŃşĘ٧˘ÖéšáľčĹĐĂĐ´Ńş     áĹĐĄŇĂŕťĹŐčšáťĹ§ăšĄŇĂ´ÓçľÓáËšč§ăš

                                        ĘҧҚľčҧ ć

           

2.      ľÍšˇŐč  2  ĄŇĂľĂǨ¤ŘłĘÁşŃľÔ˘Í§şŘ¤¤Ĺ  ăËéŕÇéšäÇé੾ŇХͧĄŇĂŕ¨éŇËšéҡŐč ĄĂÍĄ

 

3.      ľÍšˇŐč  3  ĄŇĂťĂĐŕÁÔš¤ŘłĹŃĄÉłĐ੾Ňкؤ¤Ĺ

               Ą.  ăËéźŮéşŃ§¤ŃşşŃ­ŞŇĂĐ´ŃşËŃÇËšéҧҚ ËĂ×ÍËŃÇËšéŇ˝čŇ ËĂ×ÍŕˇŐÂşŕˇčŇ

  ŕťçšźŮéťĂĐŕÁÔš áĹĐŧŞ×čÍ ľÓáËšč§ ÇŃš ŕ´×Íš ťŐ ˇŐčťĂĐŕÁÔš´éÇÂ

                     ˘.  ăËéźŮéşŃ§¤ŃşşŃ­ŞŇĂĐ´ŃşĄÍ§ ËĂ×ÍŕˇŐÂşŕˇčŇ

                           ŕťçšźŮéťĂĐŕÁÔš áĹĐŧŞ×čÍ ľÓáËšč§ ÇŃš ŕ´×Íš ťŐ ˇŐčťĂĐŕÁÔš´éÇÂ

 

4.  ľÍšˇŐč  4  áşşťĂĐŕÁÔšźĹ§Ňš (ĘÓËĂŃşĄĂĂÁĄŇĂźŮéăËé¤ĐáššĄŇĂťĂĐŕÁÔš)  äÁčľéͧ¨Ń´ˇÓ

                       ĄÍ§ĄŇĂŕ¨éŇËšéҡŐč¨ĐŕťçšźŮé´ÓŕšÔšĄŇĂŕͧ

 

5.  ľÍš  Ą   ăËéĂĐşŘĂŇÂĹĐŕÍŐ´˘Í§źĹĄŇĂťŻÔşŃľÔ§Ňš˘Í§ËščǧҚáĹТͧźŮé˘ÍĂŃşĄŇĂťĂĐŕÁÔš

                       ÂéÍšËĹѧ 2 ťŐ šŃş¨ŇĄÇŃšˇŐč˘ÍťĂĐŕÁÔš  â´ÂźĹĄŇĂťŻÔşŃľÔ§Ňš˘Í§ËščǧҚ ËÁŇÂśÖ§ 

                       źĹĄŇĂťŻÔşŃľÔ§Ňš˘Í§˝čŇ  ËĂ×ÍĄĹŘčÁ ËĂ×ͥͧ ËĂ×ÍĘӚѥˇŐčźŮé˘ÍĂŃşĄŇĂťĂĐŕÁÔšĘѧĄŃ´ÍÂŮč

                       ĘÓËĂŃş  źŮé˘ÍĂŃşĄŇĂťĂĐŕÁÔšŕž×čÍŕĹ×čÍšăËé´ÓçľÓáËšč§ŕ¨éŇËšéҡŐčşŃšˇÖĄ˘éÍÁŮĹ 4 áĹĐŕ¨éŇËšéҡŐč

                       şŃšˇÖĄ˘éÍÁŮĹ 5 äÁčľéͧ¨Ń´ˇÓľÍš Ą ŕžĂŇĐľéͧŕ˘éŇĂŃşˇ´ĘÍş¤ÇŇÁĘŇÁŇÜ㚥ŇĂăŞéŕ¤Ă×čͧ

                       ¤ÍÁžÔÇŕľÍĂě

 

6.  ľÍš  ˘   ăËéźŮé˘ÍĂŃşĄŇĂťĂĐŕÁÔšŕʚ͟ŧҚËĂ×ÍžĂóҧҚ  ŤÖ觾šŕͧŕťçšźŮ靯ԺѾԧҚ  ËĂ×Íä´é

                      ĂčÇÁťŻÔşŃľÔ§Ňš¨ĂÔ§   â´ÂăËéźŮéşŃ§¤ŃşşŃ­ŞŇŧŞ×čÍĂŃşĂͧźĹ§Ňš´éÇ    áĹПŧҚ¨Đľéͧ

                      ¤ĂÍş¤ĹŘÁˇŘĄËŃǢé͡ŐčĄÓËš´ăËéˇŃé§ 10 ËŃǢéÍ  ËŇĄľÓáËšč§ă´ĄÓËš´ăËé¨Ń´ˇÓźĹ§ŇšľÍš ˘

                      ÁŇĄĄÇčŇ 1 ŕĂ×čͧ ăËé¨Ń´ˇÓŕĂ×čͧˇŐč 2 ËĂ×ÍŕĂ×čͧˇŐč 3 ŕŞčšŕ´ŐÂÇĄŃşŕĂ×čͧˇŐč 1 

 

 

 

 

 

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ĘÓËĂŃş  źŮé˘ÍĂŃşĄŇĂťĂĐŕÁÔšŕž×čÍŕĹ×čÍšăËé´ÓçľÓáËšč§ŕ¨éŇËšéҡŐčşŃšˇÖĄ˘éÍÁŮĹ 4  áĹĐŕ¨éŇËšéҡŐč

şŃšˇÖĄ˘éÍÁŮĹ 5  äÁčľéͧ¨Ń´ˇÓľÍš ˘  ľŇÁËŃǢé͡ŐčĄÓËš´˘éҧľéššŐé  áľčăËéŕʚ͟ŧҚ ´Ń§šŐé

-  ľÓáËšč§ŕ¨éŇËšéҡŐčşŃšˇÖĄ˘éÍÁŮĹ 4 ăËéŕʚ͟ŧҚˇŐčľšŕͧťŻÔşŃľÔ ŕŞčš §ŇšžÔÁžě˚ѧĘ×ÍĂŇŞĄŇĂ

                           ˇŐčăŞé¤ÍÁžÔÇŕľÍĂě   ¨ÓšÇšäÁčľčÓĄÇčŇ 3   ŕĂ×čͧ â´ÂľéͧžÔÁžě¨ŇĄŕ¤Ă×čͧ¤ÍÁžÔÇŕľÍĂě  ˇŃé§ 4 ŞŘ´

                        -  ľÓáËšč§ŕ¨éŇËšéҡŐčşŃšˇÖĄ˘éÍÁŮĹ 5  ăËéŕʚ͟ŧҚ㚥ŇèѴˇÓáźčšľŇĂҧˇÓĄŇĂ  ¨ÓšÇš 2

                           ŕĂ×čͧ  áĹЧҚžÔÁžě˚ѧĘ×ÍĂŇŞĄŇáŐčăŞé¤ÍÁžÔÇŕľÍĂě  ¨ÓšÇš 1 ŕĂ×čͧ  â´ÂľéͧžÔÁžě¨ŇĄŕ¤Ă×čͧ

                           ¤ÍÁžÔÇŕľÍĂě  ˇŃé§ 4 ŞŘ´

 

7.  ŕÍĄĘŇäӢ͝ĂĐŕÁÔšşŘ¤¤ĹáĹĐťĂĐŕÁÔšźĹ§Ňš  ¨Đľéͧ¨Ń´ˇÓŕťçšĂŮťŕĹčÁăËéŕĂŐÂşĂéÍ ĄĂĐ´Ňɨоéͧ

      ÁŐ˘šŇ´ŕ´ŐÂÇĄŃš  ¤×Í  ˘šŇ´ A4  áĹĐăËé¨Ń´Ę觥ĂÁÍءÂŇšáËč§ŞŇľÔ ĘŃľÇěťčŇ áĹОњ¸Řěž×Ş  ¨ÓšÇš 4 ŞŘ´

 

8.      ťĄ´éҚ˚éŇáĹĐ´éŇšËĹѧ˘Í§áşşťĂĐŕÁÔšşŘ¤¤ĹáĹĐťĂĐŕÁÔšźĹ§Ňš  ¤ÇĂŕťçšĄĂĐ´ŇÉĘŐ

 

9.  ËŇĄÁŐ˘éÍʧĘŃ  ˘ÍăËéľÔ´ľčͤس¨ÔĂҞà ŔÔ­­ĘŇĘšě ËĂ×Í ¤Řł¸ÇŃŞŞŃ  ĄÔ¨šÔŕˇČ   ˝čŇÂĘĂĂËŇáĹĐşĂèŘáľč§ľŃé§

      ĄÍ§ĄŇĂŕ¨éŇËšéҡŐč   ĄĂÁÍءÂŇšáËč§ŞŇľÔ ĘŃľÇěťčŇ áĹОњ¸Řěž×Ş  âˇĂ.0-2579-8607 , 0-2561-4292-3 ľčÍ 147