Ӱⷿͬͨ11ƪ
ŷɹսռʱأֳпʹõͬԱ·ɹϵźܶѶͬеdzհɣСΪĵӰⷿͬοӭĶ
Ӱⷿͬ 1
ⷽ(¼Ƽ)_____
֤룺
ⷽ(¼ҷ)_____
֤룺
ס˫зݵЭ飺
һ ݻ
(¼Ƹ÷)____________________
ڶ ;
÷;Ϊס
˫Լ⣬ҷı䷿;
ޡ
__________________ֹ
÷Ϊ()___Ԫ
ڼ䣬йߵ߹涨֮⣬ⷽκ
ʽ
ޡ
ӦڱͬЧ֮ ڣ÷ݽҷ
ԷݲȨijŵ
֤ڽʱ÷ûвȨףЭԼ⣬йذҡѺծ˰ȣڽǰסδɼеȫΣɴ˸ҷɾʧģɼ⳥
ڰ άΡ
ڼ䣬Էݼ丽ʩÿ¼顢һΣҷӦЭʩ
ķݴɼеճķάҳе
ҷʹòɷݼ豸ʧάãҷе⳥ʧ
ڼ䣬ȫǰۺȫȹҷӦִейزŹ涨еȫκͷӼල顣
ھ ڷڼйطá
ڷڼ䣬·ҷ֧
1.ˮѣ
2.úѣ
3.ҵ
ʮ Ѻ
ʮһ
1ҷҪޣͬޣ
2δȷʾģΪͬҷ⣻
3ڣҷȷʾģӦǰһ¸֪Ӧ˻ҷ֧Ѻ
ʮ ΥԼΡ
ڼ˫غͬκһΥͬĹ涨ԷΪΥԼ
ʮ ɿԭ¸÷ݻʧģ˫еΡ
ʮ ͬδɼס˫鶨ǩЭ顣Э뱾ͬһµ.ԲЭΪ
ʮ ֮ͬΪͬɷָ֮һ֡ͬ丽ڣոдӡˢ־ͬЧ
ͬ丽ͲЭδ涨лйطɡִС
ʮ Լ
(һ)ⷽΪṩƷ£
(1)һ
(2)һ
(3)ˮһ
(4)һ
(5)һ
(6)յһ
()ǰˮȱ״
(1)ˮΪ
(2)Ϊ__ȣ
(3)úΪ__ȡ
ʮ ͬз飬ɼס˫Э̽Э̲ʱס˫Ժߡ
ʮ ͬԼס˫ǩ֮Чһʽݣס˫ִһݣͬЧнִһݱ
(ǩ)_____
ҷ(ǩ)_____
ϵ绰
ϵ绰
_________
Ӱⷿͬ 2
ⷽ(Ƽ)________________
֤룺_____________________________________
ⷽ(ҷ)________________
֤룺_____________________________________
ݹҺʡейط棬˫Э̡һͬ⣬ǩͬ£
һڽ____________ƽķݣҷ_______________ʹá
ڴ______________________________________________ֹ
ɷʽΪϴ____________ɣΪ____________Ԫҷÿ__________________ǰ______һν塣ÿһΣоС
ġͬЧҷӦ֧Լ֤______Ԫͬ˻ҷ
塢ⷿݵˮѡҵѵɳⷽ
ҷԼڽǷ______£ÿ°______%ɽǷ______ϣȨջطݣȨܾԼ֤
ߡҷԸı䷿ݵ'ṹ;ҷʧ÷ݺ豸Ļеָԭ״⳥ʧΡ
ˡڼ䷿ɿ»𣬱ͬȻֹ˫еΡ
šڼ䣬ҷδͬ⣬ýתڽͬʱҷ谴ʱ黹ݸ⣬ǰ______Э̣µЭ顣粻⣬ҷӦ______峡ϣݽ
ʮͬδˣɾ˫Э涨涨ͬͬЧ
ʮһͬзףӦͨ˫Э̽Э̲ɣ뷿ŵԺߡ
ʮͬһʽ_______ݣ˫ִһݣһݣͬȷЧ
(ǩ)_________________(ǩ)_________________
ϵ绰________________________ϵ绰________________________
______________________________________________________
Ӱⷿͬ 3
(¼Ƽ)____________
__________________________
(֤)________________
ַ__________________________
ϵ绰_____________________
(¼ҷ)____________
__________________________
(֤)________________
ַ__________________________
ϵ绰_____________________
ݵĻ______________ݽṹΪֻ죬֤Ǽ____________ƽףȨ֤____________۸÷ۼܽΪ____________Ԫд______________Ԫ
ʽҷڱͬǩ֮ȫ֧
ݽޣӦڱͬǩ֮ս÷Կסռվݽҷ(վݰסά𡢷װѺˮվ)
ڲȨǼǵ`ԼӦЭҷںͬǩ֮հȨǼвɿԭɵղܰӦ______Эϡ
Ȩתķðҵйع涨ҷǩͬʱҷվݣԴ˺ͬǩ֮˷һзҷ𣬼ٶԴ˷κΡ
ͬз飬ɼס˫Э̽Э̲ʱڵԺߡ
ͬһʽݣס˫ִһݣס˫ǩ֮ЧͬЧ
ǩ֣______________
ҷǩ֣______________
мǩ֣_____________
_________________
Ӱⷿͬ 4
_______________
ҷ_______________
һָͬΪ___________
ڶޡĽޣڹ______꣬__________________ⷿݽҷʹã__________________ջء
ü䷿ݵΪ______Ԫ(Ѻںϵֹʱ˻)
֧ʽΪ______Ѻ______⣬´νɷյǰ______֧(ڶ֧Ϊ__________________)Ϊϵˣͷϵҷ֧⣬зȫʹȨԼĹͬʹȨҷҪӺȡüͬ⡣ ҷ֮һģֹͬջطݲ˷Ѻ
1.ҷýת⣬תûתģ
2.ҷóⷿݽзǷģ
3.ҷǷۼƴµģ
4.Ӱģ
5.ǷӦɷõġ
ҷƷʩȻٻռ⳥(ƷҪ⳥)ҷ˷ĻӦǰ______¸֪Ѻˡס______£______ȡͬҷȷʵҵݰң뷿ЭӳޡҷڲǨƷΪȨƷȡʧɳⷽ⳥
ͬѺ˻ȼ뷿֮㣬˫ǰ㡣ͬ뷿˷ݣҷȨ
ڼ乲ͬ
1ڼ䣬źƽѺദ.ԭ˫ӦͬάסȫĸŶԷ˽˿ռ䡣
2סڼ䣬˫ӦšԼϧԭ˷ˮ硢úȡӦͬάʩİȫ
ͬԶ֮𣬼Ч
ͬһʽݣɼҷִһݡ
ͬ˺ͬͬЧ
ǩ֣______˾
ҷǩ֣_________________
֤ţ_________________
ϵ绰_________________
__________________
Ӱⷿͬ 5
_____ݳˣ
ҷ_____ݳˣ
ݳˣ
һַ____________________ҷʹá
ǰ_____䡣
______________________________ֹںҷҪ⣬ҷȡ
ġⷿΪ_____Ԫ˫ǩ֮ͬҷһԸ壬ݽҷʹá
塢ݳڼĹҷҷҪеһ˰ַá
ڼ䣬ҷý÷ݽеѺƭűըƷƷһΥ˵`һоʧͷԼе
ߡڼҷ⽫תʹãҷתüͬ⣬ת⡣
ˡڼ䣬ҷԷݵάޣƻṹҷҪеһзúͺе
šݳںҷҪ֤ڳڼ䣬ҷԷװޣʩأֹʱҷøκθͬ涨
ʮԲǨͷݽṹĽ⣬Ҫֹͬƽ˸ҷδʹڼ
ʮһͬס˫ΥԼһΥԼⷿ_____%еΥԼ𣬲еΥԼԷɵһоʧ
ʮͬһʽݣס˫ִһݣǩֺЧ
ǩָ£_____
ҷǩָ£_____
_______________
Ӱⷿͬ 6
ⷽ______________________
֤룺_______________________
ⷽҷ______________________
֤룺_______________________
λ______________________________ݵڶ͵Ϊҷʹãһһ䷿ΪӴң˫Эͬ⣬ִЭ飺
1ޣ__________________ֹʱΪ___ꣻ
2ңÿ___Ԫ___Ԫÿ꽻壬Ϊ___ҷޣɸʵݰʱгЭ̣ͬ£ҷޣ
3ڣף˫һҪЭ.ǰһ֪ͨԷЭ̺Э飻
4ҷӦֱΧĵ࣬÷緢ڱݵһ¹ʣҷӦȫأ
5йصһжҷӵУа棬죬ףӣȣˮյú¯ϴ»߿ߵȣ
6ҷԸıڵĽṹϧʹñݷʩΪҷҪԭ⳥緢Ȼ·ҷӦʱ֪ͨʱɼ
7δˣɼ˫Э̽Э̲ύٲûؽٲãЭһʽݣף˫ִһݣǩֺЧ
ⷽ
ⷽ
ϵ绰
ϵ绰
ǩԼڣ
_________
Ӱⷿͬ 7
ⷽ____________
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ⷽҷ____________
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ݡлͬطɷĹ涨˫ƽԸϾͼݳҷʹãҷˣΪȷ˫ȨЭһ£ͬ
һ_________________________________ֵ__________¥_____š
Ϊ________꣬____________________________________________աҷΪסʹáȨջسķݣҷӦڹ黹ҷҪ⣬һǰ֪ͨͬҷڽȫͬʱǩͬҷⷿǰ_____¸֪
Ϊ֤ͬ`ִУҷһνѺ__________Ԫ
ġ֧֧ͬʽΪֽȸáҷһȫ_____ԪΪ____________ǰ
塢ڼˮѡѡҵѡȡůѡȻѡߵӷѵȷãҷи
˫Ȩְ
1˫ںͬڼȨֹкͬӦ˫Э̽Э̲ʱӰ챾ִͬУĿ龰⣩
2ҷھסڼӦά÷ݽṹ豸ƷŴں֮ͬǰָԭòɴķҷ豸Ʒռ⳥
3ҷⷿڼ䣬Ӧ࣬ʹúȼϣӦעİȫвȫɴκκҷһе
4ҷסڼ䲻ðѴ˷ת衢תʹãøı;ô˷ݽΥʵĻøı䷿ݽṹݡ龰ȨִֹͬУɴ˸ɵʧҷе⳥
5ķɿܵԭٻҪĽʧģ˫еְԶֹͬʱʵʹʱ㡣
6˫绰Ӧʱ֪ͨԷ
ߡͬδˣ˫Э̽
ˡͬҳһʽݣɼס˫Ҽݡ
__________________ҷ__________________
ڣ__________________ڣ__________________
Ӱⷿͬ 8
ˣ
ˣҷλ
ϵַ
ϵַ
绰
绰
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Ȩˣ
绰
סҡлйطɡصطԷĹ涨ںϷƽȡԸεĻǩͬŵͬء
һҵص㼰ʩ
1ӵеλ___________ķݣ¼ơ÷ݡҷʹã;Ϊ___________Ϊ___________ƽס
2÷װʩ˫Լ⣬øΪձͬԼҷʹúҷڱͬ÷ݵ֤ݡ
1÷___________£____________________________________________ֹ
2ڣ˫δЭһ¾ǰԼ
3Ȩջظ÷ݣҷӦڽҷҪ⣬ǰһ֪ͨͬ¶ͬ
֧ʽ
1÷Ϊ___________Ԫ/£˼۸˰ѣн___________Ԫ___________ǩͬʱ֧ҷӦͬʱ_____Ԫ
2÷___________֧֧ʱΪ___________ԼʵյΪ
3ҷ֧ÿһ죬ҷ谴_____%֧ɽǷһ£Ȩջش˳ⷿҷ밴ʵʾסսеΥԼΡ
ġ
1Ӧҷʾ÷ݵIJȨ֤Ȩ÷ݳ֤
2Ӧ֤÷ݵijⲻΥҷɷع涨֤ԼȨˣǩͬ˫Ӧҹ涨б
3ҷڸ÷ڽΥɷ漰Գⷿ;йع涨Ϊ
4δͬ⣬ҷý÷ݲֻȫתˡת⣬ȨֹͬҷеԼ'ΥԼΡ
5ҷеˮѡѡʵʹõķãԼԼ
6ҷʹòʹʹ÷ݻڲʩϣҷӦʱάķáڲɿҷԭɵʧɼейάķá
7ҷʹҪԳⷿݻʩװĶ뾭ͬⲢйزȨװĶмලͬʱҷӵĽṹʩҲʩв
塢Ȩ
1ȨתƸʱرԼ£ͬµķ˼Ч
2۸÷ݣǰ֪ͨҷͬҷȹȨ
Ѻ
Ϊ˱֤ҷʹø÷ݼʩҷӦǩͬʱ֧___________ԪΪѺ𡣴鷿ҷ÷ԿͬʱѺȫ黹ҷ
ߡֹͬ
1ס˫Эһ±ֹͬ
2ҷӦսԿʹ״̬µĸƷõһƷΪȨãҷ顣
3ס˫еһΥԼһȨֹͬԷ⳥ҪнѲ˻
Эǩ֮Чұִһ
ǩ֣
ҷǩ֣
ǩ֣
ڣ
ڣ
ڣ
Ӱⷿͬ 9
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ҷ__________________
ݡлͬйطɡĹ涨˫ƽȡԸĻϣͷй˴Э£
һݻ龰
λ_______________________һһһԼ____________ƽףҷԸⷿݵ____________һ
ڶ
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ͬȨջطݣҷӦԭ״ݼ丽Ʒ豸ʩ˫ӦԷݺƷ豸ʩˮʹõ龰գӦеķá
Ѻ
һ֧ʽ_________Ԫ£ܼң_________Ԫ_________
Ѻ_________Ԫ_________ͬѺֿӦҷеķáԼҷӦеΥԼ⳥ְ⣬ʣಿӦҷ
֧ʽ_________ֽлѺ__________________Ѻǩ֮ͬո壬ҷⷿںͬʮ֮ǰ֧Ѻ
طõijеʽ
ڵзɼס˫Э̳еЭ̲ɰݳе߾̯
1ˮ
2
3ȼ
4ӷ
5ҵ
6á
ת
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1ķزϺͬԼӰҷȫģ
2еԼάʹҷʹ÷ݵģ
ģҷ֮һģȨͬջطݣ
1Լ֧Ѻʮյģ
2Ƿɸô__Ԫģ
3Ըı䷿;ģ
4ܲʹõ¸Ʒ豸ʩܲ⳥ģ
5÷ݴΥ߷ģ
6Խת˵ģ
7ݴҵ;ΥΪġ
壩ĺͬΡ
ڰΥԼְ
һҷǩͬѺֽڵˣ谴ҷ֧Ѻ⳥ҷҷֹͬģȨҪѺ
ڣǰջطݵģҷǰģӦǰ_________֪ͨԷ_____%Է֧ΥԼ𣻼Ӧ˻Ӧ龰ʱ֪ͨǨ˫ΥԼ
ھͬĽ취
ͬ·飬˫Э̽Э̲ɵģڵԺߡ
ʮԼ
ͬ˫ǩָºЧͬһʽݣмסҷִһݡ
ͬЧ˫ԺͬϵıӦȡʽΪͬĸ뱾ͬͬȵķЧ
__________________ҷ__________________
ڣ__________________ڣ__________________
Ӱⷿͬ 10
ⷽ (¼Ƽ)________________________
ⷽ (¼ҷ)________________________
˫ѺЭ̣ҷΪ˾üݣʹⷿ˴Э飺
һͬҷӪ÷_______ƽףڸù˾Ӫ֮ã÷_______
÷˫̶Ϊÿ_______Ԫ÷Ϊ_______Ԫ
ÿӳһ찴 Ʒ δɣȨջظ÷ݣʵʳٸƷҷȡ
ġҷͬԤ_______ԪΪ֤𣬺ֹͬʱ֡
塢Ϊ ______________ _______ ____________________________աڴڼ䣬κһҪֹͬǰ֪ͨԷԷ _______ΥԼתø÷ݣҷȹȨ
ø÷'طѡãҷе
ߡڳڼ䣬δͬ⣬ҷȨתת÷ݣøı䷿ݽṹ;ҷΪԭɸ÷ݼʩģҷе⳥Ρ
ˡ֤÷ȨףҷӪҪҪṩݲȨ֤й֤ϵģӦЭ
šͱͬף˫Э̽Э̲ɣκһȨԺϣ˾
ʮͬδˣ˫ЭǩЭ飬֤뱾ͬͬȷЧ
ʮһͬ˫ͬϿɲ֤Ч
(ǩ)________________________ ҷ(ǩ)________________________
(ǩ) _____________________ (ǩ)________________________
ǩʱ䣺 ___________________________ ǩʱ䣺________________________
Ӱⷿͬ 11
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˫ѺЭ̣йع涨һ´Э顣
һ ⷿݵַ
ⷿݸſ__________________________________________________________
ڼҾߵ__________________________________________________________
ڳǰⷿڼҾߵ_____ԪѺ𣬳ڼҾߵ˻Ѻ
ڶ ڹ_____________£ⷽ_____________________ⷿݽⷽʹã_____________________ջء
֮һģ˿ֹͬջطݣ
1Խת⡢תûתģ
2óⷿݽзǷġ
ֹͬʱ˵ȷʵҵݣӦӳޡҷͬȳȨ
ÿ________Ԫ(д_______________)
֧ʽΪ֧ԱͬЧ֮ڣҷӦ֧Ҽȵ___________Ԫ(д_______________)ԺӦÿһµ'µǰȵ
ڼ䣬ҷ֮ҪȻ(ڼṩȻȼ黹)ˮѡ绰ѡůѡߵӷѡʹ÷ѡѡΰѡҵõҷе
ڰ Эһʽݣ˫ǩֺЧ˫һݣЭδˣɾ˫Э涨涨ЭͬЧ
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ϵ绰___________________
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Ӱⷿͬ£
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