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ȫ 

Ѻ(¼Ƽ׷)____________ 
ˣ________ ְ____ 
 ַ________ 룺____ 绰____ 
ѺȨ(¼ҷ)____________ 
ˣ________ ְ____ 
 ַ________ 룺____ 绰____ 
׷ҪҷΪ____ ʽ˫Эһͬ⣬ڼ׷е____(¼Ƽ׷Ѻ)ΪѺѺҷ£ҷṩ˫̶Ĵ׷ڴڣ׷ӵеѺʹȨڼ׷ϢǰҷӵеѺ? 
ȨΪˣضͬ? 
һ  
1.ܽ____ Ԫ 
2.;ֻ____ ҪŲãʹôΥ 
3.ޣ 
ܽڣɷڡֱתˣڴĽޣ˫̶ֱӵڶڴ𣬱˫˫ǩָµµĵѺͬеһͽ____ 
й֤֤Ϊͬɲ֣뱾ͬͬȷЧ 
һڴΪ____ £____ ____ ____ ____ ____ ____ ֹ 
4.ʣʼϢй____ еĹ涨ִС 
5.֧ȡ 
(ڴһλǷִȡ˫̶)׷ÿӦǰ____ ֪ͨҷҷŴϿɷʹá 
һڴ____ ȡ 
6.ij 
׷֤ڸںͬ涨ĴڰϢ׷黹ʽԴΪ˾Ӫ롣׷ҪԴ黹뾭ҷͬ⡣ 
һڴ󻹿Ϊ____ ____ ____ ա 
7.ͬҷͬ׷ӳٻ¼Ч 
ڶ Ѻ 
1.Ѻƣ________________________ 
2.쳧ң________________________ 
3.ͺţ________________________ 
4.________________________ 
5.________________________ 
6.÷ŵص㣺________________________ 
7.Ѻ﷢Ʊܽ________________________ 
8.Ѻޣ____ (ΪԱͬЧ֮׷ҷ뱾ͬйصȫϢΪֹ) 
 ˫ 
(һ)ҷ 
1.Լ׷Ѻ֤ҪƱܣʧ١ 
2.ڼ׷ڻ󣬽Ѻȫݡ֤׷ 
()׷ 
1.Ӧϸպͬ涨ʱϢ 
2.֤ڵѺڼѺﲻܼ׷ƲʲָתõӰ죬ҷּ׷ѺΥڣҷ֪ͨ׷ֹͬ׷ѴȫϢ 
3.׷ӦʹΪѺ____ ѺľӪάޡй˰ȷá 
4.׷ʧɵѺӦ15ҷṩµĵѺ׷޷ṩµĵѺ򵣱ʱҷȨӦٴȣͬ׷ѴĴϢ 
5.׷δҷͬⲻýѺ⡢ۡתáٵѺʽ֡ 
6.Ѻɼ׷չ˾____ 
ͶҷΪˣյҷܣշɼ׷еͶĵѺڲɿʧҷȨӱչ˾⳥ջصѺӦĴϢ