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\ltrch\fcs0 \b\f41\fs40\cf0\insrsid10559410\charrsid10884349 Nomination Form }{\rtlch\fcs1 \ab\af0\afs40 \ltrch\fcs0 \b\f41\fs40\cf0\insrsid3807637\charrsid10884349 \par }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \b\f41\fs16\cf0\insrsid3807637\charrsid10884349 \par \ltrrow}\trowd \irow0\irowband0\ltrrow\ts11\trgaph108\trleft0\trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid10884349\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrtbl \cltxlrtb\clftsWidth3\clwWidth10368\clshdrawnil \cellx10368\pard\plain \ltrpar\s15\qc \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\pararsid4222180 \rtlch\fcs1 \af1\afs24\alang1025 \ltrch\fcs0 \f1\fs24\cf1\lang4105\langfe4105\cgrid\langnp4105\langfenp4105 {\rtlch\fcs1 \af0\afs32 \ltrch\fcs0 \f41\fs32\cf0\insrsid2777835\charrsid10884349 Emerson Douyon Multiculturalism Award Candidate}{\rtlch\fcs1 \af0\afs32 \ltrch\fcs0 \f41\fs32\cf0\insrsid3807637\charrsid10884349 \par }\pard \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\pararsid5402331 {\rtlch\fcs1 \af0 \ltrch\fcs0 \f41\cf0\insrsid5402331\charrsid10884349 \par }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \b\f41\fs16\cf0\insrsid3807637\charrsid10884349 \cell }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \f5\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid3807637\charrsid10884349 \trowd \irow0\irowband0\ltrrow \ts11\trgaph108\trleft0\trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid10884349\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrtbl \clbrdrl \brdrtbl \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrtbl \cltxlrtb\clftsWidth3\clwWidth10368\clshdrawnil \cellx10368\row \ltrrow}\trowd \irow1\irowband1\ltrrow \ts11\trgaph108\trrh323\trleft0\trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid10884349\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \clcbpat17\cltxlrtb\clftsWidth3\clwWidth10368\clcbpatraw17 \cellx10368\pard\plain \ltrpar\s15\qc \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\pararsid10032810 \rtlch\fcs1 \af1\afs24\alang1025 \ltrch\fcs0 \f1\fs24\cf1\lang4105\langfe4105\cgrid\langnp4105\langfenp4105 {\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 Nominee Information }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid4271087\charrsid10884349 \cell }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \f5\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid4222180\charrsid10884349 \trowd \irow1\irowband1\ltrrow \ts11\trgaph108\trrh323\trleft0\trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid10884349\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \clcbpat17\cltxlrtb\clftsWidth3\clwWidth10368\clcbpatraw17 \cellx10368\row \ltrrow}\trowd \irow2\irowband2\ltrrow \ts11\trgaph108\trrh445\trleft0\trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid10884349\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728\clshdrawnil \cellx1728\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3240\clshdrawnil \cellx4968\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1350\clshdrawnil \cellx6318\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4050\clshdrawnil \cellx10368\pard\plain \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0 \rtlch\fcs1 \af1\afs24\alang1025 \ltrch\fcs0 \f1\fs24\cf1\lang4105\langfe4105\cgrid\langnp4105\langfenp4105 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid10559410\charrsid10884349 Last Name}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid5070728\charrsid10884349 \~}{ \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid10559410\charrsid10884349 :}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }\pard \ltrpar \s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\pararsid4222180 {\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid10559410\charrsid10884349 \cell }\pard \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0 { \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid10559410\charrsid10884349 First Name:}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }\pard \ltrpar \s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\pararsid4222180 {\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid10559410\charrsid10884349 \cell }\pard\plain \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \f5\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid10559410\charrsid10884349 \trowd \irow2\irowband2\ltrrow \ts11\trgaph108\trrh445\trleft0\trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid10884349\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728\clshdrawnil \cellx1728\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3240\clshdrawnil \cellx4968\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1350\clshdrawnil \cellx6318\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4050\clshdrawnil \cellx10368\row \ltrrow}\trowd \irow3\irowband3\ltrrow \ts11\trgaph108\trrh460\trleft0\trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid5070728\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728\clshdrawnil \cellx1728\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3240\clshdrawnil \cellx4968\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1350\clshdrawnil \cellx6318\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4050\clshdrawnil \cellx10368\pard\plain \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\pararsid2777835 \rtlch\fcs1 \af1\afs24\alang1025 \ltrch\fcs0 \f1\fs24\cf1\lang4105\langfe4105\cgrid\langnp4105\langfenp4105 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid5070728\charrsid10884349 Work }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid4222180\charrsid10884349 a}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid5070728\charrsid10884349 ddress:}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }\pard \ltrpar \s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\pararsid4222180 {\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid5070728\charrsid10884349 \cell }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid5070728\charrsid10884349 Province:}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid5070728\charrsid10884349 \cell }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid5070728\charrsid10884349 \cell }\pard\plain \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \f5\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid5070728\charrsid10884349 \trowd \irow3\irowband3\ltrrow \ts11\trgaph108\trrh460\trleft0\trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid5070728\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728\clshdrawnil \cellx1728\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3240\clshdrawnil \cellx4968\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1350\clshdrawnil \cellx6318\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4050\clshdrawnil \cellx10368\row \ltrrow}\trowd \irow4\irowband4\ltrrow \ts11\trgaph108\trrh445\trleft0\trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid5070728\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728\clshdrawnil \cellx1728\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3240\clshdrawnil \cellx4968\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1350\clshdrawnil \cellx6318\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4050\clshdrawnil \cellx10368\pard\plain \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\pararsid2777835 \rtlch\fcs1 \af1\afs24\alang1025 \ltrch\fcs0 \f1\fs24\cf1\lang4105\langfe4105\cgrid\langnp4105\langfenp4105 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid5070728\charrsid10884349 City:}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }\pard \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\pararsid4222180 {\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid5070728\charrsid10884349 \cell }\pard \ltrpar \s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\pararsid2777835 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid5070728\charrsid10884349 Postal Code:}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }\pard \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\pararsid4222180 {\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid5070728\charrsid10884349 \cell }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \f5\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid5070728\charrsid10884349 \trowd \irow4\irowband4\ltrrow \ts11\trgaph108\trrh445\trleft0\trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid5070728\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728\clshdrawnil \cellx1728\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3240\clshdrawnil \cellx4968\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1350\clshdrawnil \cellx6318\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4050\clshdrawnil \cellx10368\row \ltrrow}\pard\plain \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\pararsid2777835 \rtlch\fcs1 \af1\afs24\alang1025 \ltrch\fcs0 \f1\fs24\cf1\lang4105\langfe4105\cgrid\langnp4105\langfenp4105 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid5070728\charrsid10884349 Position}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid15286331\charrsid10884349 - Division}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid5070728\charrsid10884349 :}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }\pard \ltrpar \s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\pararsid4222180 {\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid5070728\charrsid10884349 \cell }\pard \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0 { \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid5070728\charrsid10884349 Telephone}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid4222180\charrsid10884349 :}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }\pard \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\pararsid4222180 {\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid5070728\charrsid10884349 \cell }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \f5\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid5070728\charrsid10884349 \trowd \irow5\irowband5\ltrrow \ts11\trgaph108\trrh445\trleft0\trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid5070728\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728\clshdrawnil \cellx1728\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3240\clshdrawnil \cellx4968\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1350\clshdrawnil \cellx6318\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4050\clshdrawnil \cellx10368\row \ltrrow}\pard\plain \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0 \rtlch\fcs1 \af1\afs24\alang1025 \ltrch\fcs0 \f1\fs24\cf1\lang4105\langfe4105\cgrid\langnp4105\langfenp4105 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid9638394\charrsid10884349 E-mai}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid14048046\charrsid10884349 l}{ \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid9638394\charrsid10884349 :}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }\pard \ltrpar \s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\pararsid4222180 {\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid9638394\charrsid10884349 \cell }\pard \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0 { \rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid9638394\charrsid10884349 Cellular:}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }\pard \ltrpar \s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\pararsid4222180 {\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid9638394\charrsid10884349 \cell }\pard\plain \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \f5\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid9638394\charrsid10884349 \trowd \irow6\irowband6\lastrow \ltrrow \ts11\trgaph108\trrh445\trleft0\trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid9638394\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728\clshdrawnil \cellx1728\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3240\clshdrawnil \cellx4968\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1350\clshdrawnil \cellx6318\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4050\clshdrawnil \cellx10368\row }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid2753292\charrsid10884349 \par \ltrrow}\trowd \irow0\irowband0\ltrrow\ts28\trgaph108\trrh460\trleft5\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid12480334\tbllkhdrrows\tbllkhdrcols\tbllknocolband\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb \brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth828\clshdrawnil \cellx833\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1800\clshdrawnil \cellx2633 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth599\clshdrawnil \cellx3232\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr \brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth2101\clshdrawnil \cellx5333\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth540\clshdrawnil \cellx5873\clvertalt\clbrdrt \brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3780\clshdrawnil \cellx9653\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth720\clshdrawnil \cellx10373\pard\plain \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\yts28 \rtlch\fcs1 \af1\afs24\alang1025 \ltrch\fcs0 \f1\fs24\cf1\lang4105\langfe4105\cgrid\langnp4105\langfenp4105 { \rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid5070728\charrsid10884349 Status:}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid5070728\charrsid10884349 CSC employee:}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\f41\cf0\insrsid5070728\charrsid10884349 {\field{\*\fldinst SYMB OL 114 \\f "Wingdings" \\s 12}{\fldrslt\f10\fs24}}}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\f41\cf0\insrsid2777835\charrsid10884349 \cell }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid5070728\charrsid10884349 Within an }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid4222180\charrsid10884349 i}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid5070728\charrsid10884349 nstitution: }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\f41\cf0\insrsid5070728\charrsid10884349 {\field{\*\fldinst SYMBOL 114 \\f "Wingdings" \\s 12}{\fldrslt\f10\fs24}}}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\f41\cf0\insrsid2777835\charrsid10884349 \cell }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 Member of the public}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid15744030\charrsid10884349 :}{ \rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 \par \cell }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\f41\cf0\insrsid5070728\charrsid10884349 {\field{\*\fldinst SYMBOL 114 \\f "Wingdings" \\s 12}{\fldrslt\f10\fs24}}}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\f41\cf0\insrsid2777835\charrsid10884349 \cell }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \f5\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid5070728\charrsid10884349 \trowd \irow0\irowband0\ltrrow\ts28\trgaph108\trrh460\trleft5\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv \brdrs\brdrw10 \trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid12480334\tbllkhdrrows\tbllkhdrcols\tbllknocolband\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth828\clshdrawnil \cellx833\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1800\clshdrawnil \cellx2633\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth599\clshdrawnil \cellx3232\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr \brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth2101\clshdrawnil \cellx5333\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth540\clshdrawnil \cellx5873\clvertalt\clbrdrt \brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3780\clshdrawnil \cellx9653\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth720\clshdrawnil \cellx10373\row \ltrrow}\pard\plain \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\yts28 \rtlch\fcs1 \af1\afs24\alang1025 \ltrch\fcs0 \f1\fs24\cf1\lang4105\langfe4105\cgrid\langnp4105\langfenp4105 {\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid5070728\charrsid10884349 Volunteer\~ :}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\f41\cf0\insrsid5070728\charrsid10884349 {\field{\*\fldinst SYMBOL 114 \\f "Wingdings" \\s 12}{\fldrslt\f10\fs24}}}{ \rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\f41\cf0\insrsid2777835\charrsid10884349 \cell }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid5070728\charrsid10884349 Within the }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid4222180\charrsid10884349 c}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid5070728\charrsid10884349 ommunity:}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\f41\cf0\insrsid5070728\charrsid10884349 {\field{\*\fldinst SYMBOL 114 \\f "Wingdings" \\s 12}{\fldrslt\f10\fs24}}}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\f41\cf0\insrsid2777835\charrsid10884349 \cell }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid5070728\charrsid10884349 Other\~(specify)}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid15744030\charrsid10884349 :}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\f41\cf0\insrsid5070728\charrsid10884349 {\field{\*\fldinst SYMBOL 114 \\f "Wingdings" \\s 12}{\fldrslt\f10\fs24}}}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\f41\cf0\insrsid2777835\charrsid10884349 \cell }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \f5\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid5070728\charrsid10884349 \trowd \irow1\irowband1\lastrow \ltrrow\ts28\trgaph108\trrh460\trleft5\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid12480334\tbllkhdrrows\tbllkhdrcols\tbllknocolband\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl \brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth828\clshdrawnil \cellx833\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1800\clshdrawnil \cellx2633\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth599\clshdrawnil \cellx3232\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth2101\clshdrawnil \cellx5333\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth540\clshdrawnil \cellx5873\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3780\clshdrawnil \cellx9653\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth720\clshdrawnil \cellx10373\row }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid5070728\charrsid10884349 \par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid2753292\charrsid10884349 \par \ltrrow}\trowd \irow0\irowband0\ltrrow\ts28\trgaph108\trleft5\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid10693051\tbllkhdrrows\tbllkhdrcols\tbllknocolband\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb \brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth10368\clshdrawnil \cellx10373\pard\plain \ltrpar\s15\qc \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\yts28 \rtlch\fcs1 \af1\afs24\alang1025 \ltrch\fcs0 \f1\fs24\cf1\lang4105\langfe4105\cgrid\langnp4105\langfenp4105 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid5070728\charrsid10884349 Sponsor Information}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid4222180\charrsid10884349 }{ \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \f5\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid5070728\charrsid10884349 \trowd \irow0\irowband0\ltrrow\ts28\trgaph108\trleft5\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid10693051\tbllkhdrrows\tbllkhdrcols\tbllknocolband\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb \brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth10368\clshdrawnil \cellx10373\row \ltrrow}\trowd \irow1\irowband1\ltrrow\ts28\trgaph108\trrh445\trleft5\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr \brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid10693051\tbllkhdrrows\tbllkhdrcols\tbllknocolband\tblind0\tblindtype3 \clvertalt \clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728\clshdrawnil \cellx1733\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4140\clshdrawnil \cellx5873\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1710\clshdrawnil \cellx7583\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth2790\clshdrawnil \cellx10373\pard\plain \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\yts28 \rtlch\fcs1 \af1\afs24\alang1025 \ltrch\fcs0 \f1\fs24\cf1\lang4105\langfe4105\cgrid\langnp4105\langfenp4105 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid5070728\charrsid10884349 Last Name\~:}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid5070728\charrsid10884349 First Name:}{ \rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }\pard\plain \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \f5\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid5070728\charrsid10884349 \trowd \irow1\irowband1\ltrrow\ts28\trgaph108\trrh445\trleft5\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv \brdrs\brdrw10 \trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid10693051\tbllkhdrrows\tbllkhdrcols\tbllknocolband\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728\clshdrawnil \cellx1733\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4140\clshdrawnil \cellx5873\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1710\clshdrawnil \cellx7583\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth2790\clshdrawnil \cellx10373\row \ltrrow}\trowd \irow2\irowband2\ltrrow\ts28\trgaph108\trrh460\trleft5\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh \brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid10693051\tbllkhdrrows\tbllkhdrcols\tbllknocolband\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728\clshdrawnil \cellx1733\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4140\clshdrawnil \cellx5873\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1710\clshdrawnil \cellx7583\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth2790\clshdrawnil \cellx10373\pard\plain \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\yts28 \rtlch\fcs1 \af1\afs24\alang1025 \ltrch\fcs0 \f1\fs24\cf1\lang4105\langfe4105\cgrid\langnp4105\langfenp4105 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid5070728\charrsid10884349 Work }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid4222180\charrsid10884349 a}{ \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid5070728\charrsid10884349 ddress:}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid5070728\charrsid10884349 Province:}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \f5\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid5070728\charrsid10884349 \trowd \irow2\irowband2\ltrrow\ts28\trgaph108\trrh460\trleft5\trbrdrt\brdrs\brdrw10 \trbrdrl \brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid10693051\tbllkhdrrows\tbllkhdrcols\tbllknocolband\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb \brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728\clshdrawnil \cellx1733\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4140\clshdrawnil \cellx5873 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1710\clshdrawnil \cellx7583\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr \brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth2790\clshdrawnil \cellx10373\row \ltrrow}\trowd \irow3\irowband3\ltrrow\ts28\trgaph108\trrh445\trleft5\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh \brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid10693051\tbllkhdrrows\tbllkhdrcols\tbllknocolband\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728\clshdrawnil \cellx1733\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4140\clshdrawnil \cellx5873\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1710\clshdrawnil \cellx7583\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth2790\clshdrawnil \cellx10373\pard\plain \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\yts28 \rtlch\fcs1 \af1\afs24\alang1025 \ltrch\fcs0 \f1\fs24\cf1\lang4105\langfe4105\cgrid\langnp4105\langfenp4105 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid5070728\charrsid10884349 City:}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid5070728\charrsid10884349 Postal Code:}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \f5\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid5070728\charrsid10884349 \trowd \irow3\irowband3\ltrrow \ts28\trgaph108\trrh445\trleft5\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid10693051\tbllkhdrrows\tbllkhdrcols\tbllknocolband\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb \brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728\clshdrawnil \cellx1733\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4140\clshdrawnil \cellx5873 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1710\clshdrawnil \cellx7583\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr \brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth2790\clshdrawnil \cellx10373\row \ltrrow}\pard\plain \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\yts28 \rtlch\fcs1 \af1\afs24\alang1025 \ltrch\fcs0 \f1\fs24\cf1\lang4105\langfe4105\cgrid\langnp4105\langfenp4105 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid15286331\charrsid10884349 Position }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid4222180\charrsid10884349 \endash }{ \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid15286331\charrsid10884349 Division:}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }\pard \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\pararsid2777835\yts28 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid15286331\charrsid10884349 Telephone}{ \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid7079254\charrsid10884349 :}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }\pard \ltrpar \s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\yts28 {\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }\pard\plain \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \f5\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid15286331\charrsid10884349 \trowd \irow4\irowband4\ltrrow\ts28\trgaph108\trrh445\trleft5\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv \brdrs\brdrw10 \trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid10693051\tbllkhdrrows\tbllkhdrcols\tbllknocolband\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728\clshdrawnil \cellx1733\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4140\clshdrawnil \cellx5873\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1710\clshdrawnil \cellx7583\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth2790\clshdrawnil \cellx10373\row \ltrrow}\pard\plain \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\yts28 \rtlch\fcs1 \af1\afs24\alang1025 \ltrch\fcs0 \f1\fs24\cf1\lang4105\langfe4105\cgrid\langnp4105\langfenp4105 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid9638394\charrsid10884349 E-mail:}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }{ \rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid9638394\charrsid10884349 Cellular:}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \f5\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid9638394\charrsid10884349 \trowd \irow5\irowband5\lastrow \ltrrow \ts28\trgaph108\trrh445\trleft5\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid10693051\tbllkhdrrows\tbllkhdrcols\tbllknocolband\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb \brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728\clshdrawnil \cellx1733\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4140\clshdrawnil \cellx5873 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1710\clshdrawnil \cellx7583\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr \brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth2790\clshdrawnil \cellx10373\row }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid14371174\charrsid10884349 \par \ltrrow}\trowd \irow0\irowband0\ltrrow\ts28\trgaph108\trrh460\trleft5\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid10693051\tbllkhdrrows\tbllkhdrcols\tbllknocolband\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb \brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth828\clshdrawnil \cellx833\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth2700\clshdrawnil \cellx3533 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth540\clshdrawnil \cellx4073\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr \brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1170\clshdrawnil \cellx5243\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth450\clshdrawnil \cellx5693\clvertalt\clbrdrt \brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3960\clshdrawnil \cellx9653\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth720\clshdrawnil \cellx10373\pard\plain \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\yts28 \rtlch\fcs1 \af1\afs24\alang1025 \ltrch\fcs0 \f1\fs24\cf1\lang4105\langfe4105\cgrid\langnp4105\langfenp4105 { \rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid5070728\charrsid10884349 Status:}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid5070728\charrsid10884349 Employee Supervisor}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid4222180\charrsid10884349 or }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid15286331\charrsid10884349 Manager }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid7079254\charrsid10884349 :}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \f41\cf0\insrsid5070728\charrsid10884349 {\field{\*\fldinst SYMBOL 114 \\f "Wingdings" \\s 12}{\fldrslt\f10\fs24}}}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \f41\cf0\insrsid2777835\charrsid10884349 \cell }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid5070728\charrsid10884349 Colleague}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid7079254\charrsid10884349 \~:}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }{ \rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\f41\cf0\insrsid5070728\charrsid10884349 {\field{\*\fldinst SYMBOL 114 \\f "Wingdings" \\s 12}{\fldrslt\f10\fs24}}}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\f41\cf0\insrsid2777835\charrsid10884349 \cell }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid5070728\charrsid10884349 Member of the }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid4222180\charrsid10884349 p}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid5070728\charrsid10884349 ublic\~}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid4222180\charrsid10884349 :}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \f41\cf0\insrsid5070728\charrsid10884349 {\field{\*\fldinst SYMBOL 114 \\f "Wingdings" \\s 12}{\fldrslt\f10\fs24}}}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \f41\cf0\insrsid2777835\charrsid10884349 \cell }\pard\plain \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \f5\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid9638394\charrsid10884349 \trowd \irow0\irowband0\ltrrow\ts28\trgaph108\trrh460\trleft5\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv \brdrs\brdrw10 \trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid10693051\tbllkhdrrows\tbllkhdrcols\tbllknocolband\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth828\clshdrawnil \cellx833\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth2700\clshdrawnil \cellx3533\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth540\clshdrawnil \cellx4073\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr \brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1170\clshdrawnil \cellx5243\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth450\clshdrawnil \cellx5693\clvertalt\clbrdrt \brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3960\clshdrawnil \cellx9653\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth720\clshdrawnil \cellx10373\row \ltrrow}\pard\plain \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\yts28 \rtlch\fcs1 \af1\afs24\alang1025 \ltrch\fcs0 \f1\fs24\cf1\lang4105\langfe4105\cgrid\langnp4105\langfenp4105 {\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }\pard \ltrpar\s15\ql \li0\ri0\widctlpar\intbl \tqc\tx4680\tqr\tx9360\wrapdefault\faauto\rin0\lin0\yts28 {\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 Volunteer\~supervisor:\cell }\pard \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\yts28 {\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \f41\cf0\insrsid5070728\charrsid10884349 {\field{\*\fldinst SYMBOL 114 \\f "Wingdings" \\s 12}{\fldrslt\f10\fs24}}}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \f41\cf0\insrsid2777835\charrsid10884349 \cell }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid5070728\charrsid10884349 Friend\~:}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\f41\cf0\insrsid5070728\charrsid10884349 {\field{\*\fldinst SYMBOL 114 \\f "Wingdings" \\s 12}{\fldrslt\f10\fs24}}}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\f41\cf0\insrsid2777835\charrsid10884349 \cell }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid5070728\charrsid10884349 Other\~ (specify):}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \f41\cf0\insrsid5070728\charrsid10884349 {\field{\*\fldinst SYMBOL 114 \\f "Wingdings" \\s 12}{\fldrslt\f10\fs24}}}{ \rtlch\fcs1 \ab\af0 \ltrch\fcs0 \f41\cf0\insrsid2777835\charrsid10884349 \cell }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \f5\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid9638394\charrsid10884349 \trowd \irow1\irowband1\lastrow \ltrrow\ts28\trgaph108\trrh460\trleft5\trbrdrt\brdrs\brdrw10 \trbrdrl \brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid10693051\tbllkhdrrows\tbllkhdrcols\tbllknocolband\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb \brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth828\clshdrawnil \cellx833\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth2700\clshdrawnil \cellx3533 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth540\clshdrawnil \cellx4073\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr \brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1170\clshdrawnil \cellx5243\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth450\clshdrawnil \cellx5693\clvertalt\clbrdrt \brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3960\clshdrawnil \cellx9653\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth720\clshdrawnil \cellx10373\row }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid5070728\charrsid10884349 \par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid5402331\charrsid10884349 \page \par }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 Justification}{\rtlch\fcs1 \af0 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid5070728\charrsid10884349 \par \ltrrow}\trowd \irow0\irowband0\ltrrow\ts11\trgaph108\trrh460\trleft5\trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid7810015\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0 \tblindtype3 \clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3456\clshdrawnil \cellx3461\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth972\clshdrawnil \cellx4433\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1530\clshdrawnil \cellx5963\clvertalb \clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth990\clshdrawnil \cellx6953\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3420\clshdrawnil \cellx10373\pard\plain \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0 \rtlch\fcs1 \af1\afs24\alang1025 \ltrch\fcs0 \f1\fs24\cf1\lang4105\langfe4105\cgrid\langnp4105\langfenp4105 { \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid7810015\charrsid10884349 Additional pages attached:}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid7810015\charrsid10884349 Yes\~:}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }\pard \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\pararsid7810015 {\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \f41\cf0\insrsid7810015\charrsid10884349 {\field{\*\fldinst SYMBOL 114 \\f "Wingdings" \\s 12}{\fldrslt\f10\fs24}}}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \f41\cf0\insrsid7810015\charrsid10884349 \cell }\pard \ltrpar \s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0 {\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\f41\fs20\cf0\insrsid7810015\charrsid10884349 No\~:}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid2777835\charrsid10884349 \cell }\pard \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\pararsid7810015 {\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \f41\cf0\insrsid7810015\charrsid10884349 {\field{\*\fldinst SYMBOL 114 \\f "Wingdings" \\s 12}{\fldrslt\f10\fs24}}}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \f41\cf0\insrsid7810015\charrsid10884349 \cell }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \f5\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 \trowd \irow0\irowband0\ltrrow \ts11\trgaph108\trrh460\trleft5\trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid7810015\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3456\clshdrawnil \cellx3461\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth972\clshdrawnil \cellx4433\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1530\clshdrawnil \cellx5963\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth990\clshdrawnil \cellx6953\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3420\clshdrawnil \cellx10373\row \ltrrow}\trowd \irow1\irowband1\ltrrow \ts11\trgaph108\trrh460\trleft5\trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid1201382\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth10368\clshdrawnil \cellx10373{\listtext\pard\plain\ltrpar \s16 \intbl\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \f1\fs20\lang1024\langfe1024\noproof\langnp1033\insrsid10884349 \hich\af1\dbch\af0\loch\f1 1.\tab}\pard\plain \ltrpar\s16\ql \fi-360\li360\ri0\sb19\nowidctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\ls3\adjustright\rin0\lin360\pararsid1201382 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 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\cltxlrtb\clftsWidth3\clwWidth10368\clshdrawnil \cellx10373\row \ltrrow{\listtext\pard\plain\ltrpar \s16 \intbl\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \f1\fs20\lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 \hich\af1\dbch\af0\loch\f1 2.\tab}}\pard\plain \ltrpar\s16\ql \fi-360\li360\ri0\sb14\nowidctlpar\intbl \tqc\tx4680\tqr\tx9360\wrapdefault\aspalpha\aspnum\faauto\ls3\adjustright\rin0\lin360\pararsid1201382 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 The}{\rtlch\fcs1 \af1 \ltrch\fcs0 \expnd-2\expndtw-14\lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 candidate}{\rtlch\fcs1 \af1 \ltrch\fcs0 \expnd-1\expndtw-6\lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 demonstrates}{\rtlch\fcs1 \af1 \ltrch\fcs0 \expnd1\expndtw5\lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 support}{\rtlch\fcs1 \af1 \ltrch\fcs0 \expnd-2\expndtw-10\lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 to}{\rtlch\fcs1 \af1 \ltrch\fcs0 \expnd-2\expndtw-13\lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 the}{\rtlch\fcs1 \af1 \ltrch\fcs0 \expnd0\expndtw-1\lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 reintegration}{\rtlch\fcs1 \af1 \ltrch\fcs0 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\li360\ri0\sb14\nowidctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin360\pararsid1201382 {\rtlch\fcs1 \af1 \ltrch\fcs0 \i\expnd0\expndtw1\lang4105\langfe1033\langnp4105\insrsid1201382\charrsid10884349 \par }{\rtlch\fcs1 \af1 \ltrch\fcs0 \expnd0\expndtw1\lang4105\langfe1033\langnp4105\insrsid1201382\charrsid10884349 \par \par \par \par \par \par \par \par \par }\pard \ltrpar\s16\ql \li1476\ri0\sb14\nowidctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin1476\pararsid1201382 {\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid1201382\charrsid10884349 \cell }\pard\plain \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \f5\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid5070728\charrsid10884349 \trowd \irow2\irowband2\ltrrow 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\af1\afs20 \ltrch\fcs0 \fs20\expnd7\expndtw38\cf0\charscalex97\insrsid7810015\charrsid10884349 }{\rtlch\fcs1 \af1\afs20 \ltrch\fcs0 \fs20\cf0\insrsid7810015\charrsid10884349 among}{\rtlch\fcs1 \af1\afs20 \ltrch\fcs0 \fs20\expnd-3\expndtw-17\cf0\insrsid7810015\charrsid10884349 }{\rtlch\fcs1 \af1\afs20 \ltrch\fcs0 \fs20\cf0\insrsid7810015\charrsid10884349 ethnocultural}{\rtlch\fcs1 \af1\afs20 \ltrch\fcs0 \fs20\expnd0\expndtw2\cf0\insrsid7810015\charrsid10884349 }{\rtlch\fcs1 \af1\afs20 \ltrch\fcs0 \fs20\cf0\insrsid7810015\charrsid10884349 offenders}{\rtlch\fcs1 \af1\afs20 \ltrch\fcs0 \fs20\expnd0\expndtw3\cf0\insrsid1201382\charrsid10884349 .}{\rtlch\fcs1 \af1\afs20 \ltrch\fcs0 \fs20\cf0\insrsid5070728\charrsid10884349 \par }\pard \ltrpar\s15\ql \li360\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin360\pararsid1201382 {\rtlch\fcs1 \af1\afs20 \ltrch\fcs0 \fs20\cf0\insrsid1201382\charrsid10884349 \par \par \par \par \par \par \par \par \par \par \cell }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \f5\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid5070728\charrsid10884349 \trowd \irow3\irowband3\lastrow \ltrrow \ts11\trgaph108\trrh460\trleft5\trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid1201382\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth10368\clshdrawnil \cellx10373\row }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid5402331\charrsid10884349 \par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid2777835\charrsid10884349 \page }{\rtlch\fcs1 \af0 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid5402331\charrsid10884349 \par \par \ltrrow{\listtext\pard\plain\ltrpar \s16 \intbl\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \f1\fs20\lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 \hich\af1\dbch\af0\loch\f1 4.\tab}}\pard\plain \ltrpar\s16\ql \fi-360\li360\ri1425\sb14\sl242\slmult1 \nowidctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\ls3\adjustright\rin1425\lin360\pararsid1201382 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 The}{\rtlch\fcs1 \af1 \ltrch\fcs0 \expnd7\expndtw36\lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 candidate}{\rtlch\fcs1 \af1 \ltrch\fcs0 \expnd9\expndtw47\lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 promotes}{\rtlch\fcs1 \af1 \ltrch\fcs0 \expnd9\expndtw46\lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 inter-cultural}{\rtlch\fcs1 \af1 \ltrch\fcs0 \expnd9\expndtw48\lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 understanding}{\rtlch\fcs1 \af1 \ltrch\fcs0 \expnd8\expndtw40\lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 and}{\rtlch\fcs1 \af1 \ltrch\fcs0 \expnd7\expndtw37\lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \expnd0\expndtw-2\lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 Canadian}{\rtlch\fcs1 \af1 \ltrch\fcs0 \expnd6\expndtw32\lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 values}{\rtlch\fcs1 \af1 \ltrch\fcs0 \expnd9\expndtw48\lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 (democracy,}{\rtlch\fcs1 \af1 \ltrch\fcs0 \expnd3\expndtw19\lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 freedom,}{\rtlch\fcs1 \af1 \ltrch\fcs0 \expnd4\expndtw24\lang4105\langfe1033\charscalex110\langnp4105\insrsid7810015\charrsid10884349 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 human}{\rtlch\fcs1 \af1 \ltrch\fcs0 \expnd8\expndtw44\lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 rights}{\rtlch\fcs1 \af1 \ltrch\fcs0 \expnd9\expndtw46\lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 and}{\rtlch\fcs1 \af1 \ltrch\fcs0 \expnd9\expndtw45\lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid1509491\charrsid10884349 rule of }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 law}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid1509491\charrsid10884349 )}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 within CSC, through}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid1509491\charrsid10884349 institutional or}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 community initiatives, with the objectives of addressing}{\rtlch\fcs1 \af1 \ltrch\fcs0 \expnd0\expndtw1\lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 issues}{\rtlch\fcs1 \af1 \ltrch\fcs0 \expnd-2\expndtw-10\lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 of}{\rtlch\fcs1 \af1 \ltrch\fcs0 \expnd-1\expndtw-9\lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 cultural}{\rtlch\fcs1 \af1 \ltrch\fcs0 \expnd-2\expndtw-11\lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 social}{\rtlch\fcs1 \af1 \ltrch\fcs0 \expnd0\expndtw-4\lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 exclusion and}{\rtlch\fcs1 \af1 \ltrch\fcs0 \expnd-1\expndtw-7\lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 radicalization}{\rtlch\fcs1 \af1 \ltrch\fcs0 \expnd-6\expndtw-30\lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 .}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 \par }\pard\plain \ltrpar\s15\qj \li360\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin360\pararsid2753292 \rtlch\fcs1 \af1\afs24\alang1025 \ltrch\fcs0 \f1\fs24\cf1\lang4105\langfe4105\cgrid\langnp4105\langfenp4105 {\rtlch\fcs1 \af1\afs20 \ltrch\fcs0 \fs20\cf0\insrsid5070728\charrsid10884349 \par }{\rtlch\fcs1 \af1\afs20 \ltrch\fcs0 \fs20\cf0\insrsid2753292\charrsid10884349 \par \par \par \par \par \par \par \par \par \cell }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \f5\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid5070728\charrsid10884349 \trowd \irow0\irowband0\ltrrow \ts11\trgaph108\trrh460\trleft5\trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid1201382\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth10368\clshdrawnil \cellx10373\row \ltrrow{\listtext\pard\plain\ltrpar \s16 \intbl\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \f1\fs20\lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 \hich\af1\dbch\af0\loch\f1 5.\tab}}\pard\plain \ltrpar\s16\ql \fi-360\li360\ri0\sb12\nowidctlpar\intbl \tx1170\wrapdefault\aspalpha\aspnum\faauto\ls3\adjustright\rin0\lin360\pararsid1201382 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 The}{\rtlch\fcs1 \af1 \ltrch\fcs0 \expnd-1\expndtw-7\lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \cf1\lang4105\langfe4105\langnp4105\langfenp4105\insrsid1509491\charrsid10884349 nomination package demonstrates that the candidate has had a positive impact on the workplace and/or within their community}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7810015\charrsid10884349 . \par }\pard \ltrpar\s16\ql \li360\ri0\sb12\nowidctlpar\intbl\tx1170\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin360\pararsid2753292 {\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid2753292\charrsid10884349 \par \par \par \par \par \par \par \par \par \par }\pard\plain \ltrpar\s15\ql \fi-360\li360\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin360\pararsid1201382 \rtlch\fcs1 \af1\afs24\alang1025 \ltrch\fcs0 \f1\fs24\cf1\lang4105\langfe4105\cgrid\langnp4105\langfenp4105 {\rtlch\fcs1 \af1\afs20 \ltrch\fcs0 \fs20\cf0\insrsid5070728\charrsid10884349 \cell }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \f5\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid5070728\charrsid10884349 \trowd \irow1\irowband1\lastrow \ltrrow \ts11\trgaph108\trrh460\trleft5\trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid1201382\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth10368\clshdrawnil \cellx10373\row }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af1\afs20 \ltrch\fcs0 \f1\fs20\lang4105\langfe1033\langnp4105\insrsid2753292\charrsid10884349 \par }{\rtlch\fcs1 \af1\afs20 \ltrch\fcs0 \f1\fs20\lang4105\langfe1033\langnp4105\insrsid15286331\charrsid10884349 \par }{\rtlch\fcs1 \af1\afs20 \ltrch\fcs0 \f1\fs20\lang4105\langfe1033\langnp4105\insrsid2753292\charrsid10884349 \par Approval \par \ltrrow}\trowd \irow0\irowband0\ltrrow\ts11\trgaph108\trrh935\trleft5\trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid16269694\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0 \tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3618\clshdrawnil \cellx3623\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth2790\clshdrawnil \cellx6413\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth2340\clshdrawnil \cellx8753\clvertalt \clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1620\clshdrawnil \cellx10373\pard\plain \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\pararsid16269694 \rtlch\fcs1 \af1\afs24\alang1025 \ltrch\fcs0 \f1\fs24\cf1\lang4105\langfe4105\cgrid\langnp4105\langfenp4105 {\rtlch\fcs1 \af1\afs20 \ltrch\fcs0 \fs20\cf0\insrsid2753292\charrsid10884349 Sponsor\rquote s Signature}{\rtlch\fcs1 \af1\afs20 \ltrch\fcs0 \fs20\cf18\insrsid7079254\charrsid10884349 \~:}{\rtlch\fcs1 \ab\af1\afs20 \ltrch\fcs0 \fs20\cf0\insrsid2777835\charrsid10884349 \cell }\pard \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\pararsid15286331 {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \f41\fs16\cf0\insrsid15286331\charrsid10884349 Name in script letters:}{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \f41\fs16\cf0\insrsid2753292\charrsid10884349 \par }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid15286331\charrsid10884349 \par \cell }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \f41\fs16\cf0\insrsid15286331\charrsid10884349 Signature\~}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid15286331\charrsid10884349 :}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid2753292\charrsid10884349 \par }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid6241613\charrsid10884349 \cell }\pard \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\pararsid2753292 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \f41\fs16\cf0\insrsid15286331\charrsid10884349 Date}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \f41\fs16\cf0\insrsid6883773\charrsid10884349 }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \f41\fs16\cf0\insrsid15286331\charrsid10884349 :}{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \b\f41\fs16\cf0\insrsid2753292\charrsid10884349 \cell }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \f5\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid2753292\charrsid10884349 \trowd \irow0\irowband0\ltrrow \ts11\trgaph108\trrh935\trleft5\trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid16269694\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3618\clshdrawnil \cellx3623\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth2790\clshdrawnil \cellx6413\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth2340\clshdrawnil \cellx8753\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1620\clshdrawnil \cellx10373\row \ltrrow}\trowd \irow1\irowband1\ltrrow \ts11\trgaph108\trrh926\trleft5\trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid16269694\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3618\clshdrawnil \cellx3623\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth2790\clshdrawnil \cellx6413\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth2340\clshdrawnil \cellx8753\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1620\clshdrawnil \cellx10373\pard\plain \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\pararsid16269694 \rtlch\fcs1 \af1\afs24\alang1025 \ltrch\fcs0 \f1\fs24\cf1\lang4105\langfe4105\cgrid\langnp4105\langfenp4105 {\rtlch\fcs1 \af1\afs20 \ltrch\fcs0 \fs20\cf0\insrsid2753292\charrsid10884349 Candidate\rquote s Manager Signature}{\rtlch\fcs1 \af1\afs20 \ltrch\fcs0 \fs20\cf0\insrsid7079254\charrsid10884349 \~:}{\rtlch\fcs1 \af1\afs20 \ltrch\fcs0 \fs20\cf0\insrsid2777835\charrsid10884349 \cell }\pard \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\tqc\tx4680\tqr\tx9360\wrapdefault\faauto\rin0\lin0\pararsid15286331 { \rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \f41\fs16\cf0\insrsid15286331\charrsid10884349 Name in script }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \f41\fs16\cf0\insrsid9382592\charrsid10884349 letters }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid9382592\charrsid10884349 :}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid2753292\charrsid10884349 \par }\pard \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\pararsid15286331 {\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid15286331\charrsid10884349 \par \cell }\pard \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\pararsid12340144 {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \f41\fs16\cf0\insrsid12340144\charrsid10884349 Signature\~}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid12340144\charrsid10884349 : \par }\pard \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\pararsid15286331 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid2753292\charrsid10884349 \cell }\pard \ltrpar \s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\pararsid2753292 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \f41\fs16\cf0\insrsid15286331\charrsid10884349 Date}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \f41\fs16\cf0\insrsid6883773\charrsid10884349 }{ \rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \f41\fs16\cf0\insrsid15286331\charrsid10884349 :}{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \b\f41\fs16\cf0\insrsid2753292\charrsid10884349 \cell }\pard\plain \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \f5\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid2753292\charrsid10884349 \trowd \irow1\irowband1\ltrrow 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\f1\fs24\cf1\lang4105\langfe4105\cgrid\langnp4105\langfenp4105 {\rtlch\fcs1 \af1\afs20 \ltrch\fcs0 \fs20\cf0\insrsid8659257\charrsid10884349 Candidate\rquote s Director }{\rtlch\fcs1 \af1\afs20 \ltrch\fcs0 \fs20\cf0\insrsid9382592\charrsid10884349 Signature}{\rtlch\fcs1 \af1\afs20 \ltrch\fcs0 \i\fs20\cf0\insrsid9382592\charrsid10884349 :}{\rtlch\fcs1 \af1\afs20 \ltrch\fcs0 \fs20\cf0\insrsid2777835\charrsid10884349 \cell }\pard \ltrpar \s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\pararsid15286331 {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \f41\fs16\cf0\insrsid15286331\charrsid10884349 Name in script letters}{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \f41\fs16\cf0\insrsid15744030\charrsid10884349 \~:}{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \f41\fs16\cf0\insrsid8659257\charrsid10884349 \par }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid15286331\charrsid10884349 \par \cell }\pard \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\pararsid12340144 {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \f41\fs16\cf0\insrsid12340144\charrsid10884349 Signature\~}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid12340144\charrsid10884349 : \par }\pard \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\pararsid15286331 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid8659257\charrsid10884349 \cell }\pard \ltrpar \s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\pararsid2753292 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \f41\fs16\cf0\insrsid15286331\charrsid10884349 Date\~:}{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \b\f41\fs16\cf0\insrsid8659257\charrsid10884349 \cell }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \f5\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid8659257\charrsid10884349 \trowd \irow2\irowband2\ltrrow \ts11\trgaph108\trrh828\trleft5\trftsWidth3\trwWidth10368\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid16269694\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3618\clshdrawnil \cellx3623\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth2790\clshdrawnil \cellx6413\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth2340\clshdrawnil \cellx8753\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1620\clshdrawnil \cellx10373\row \ltrrow}\pard\plain \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\pararsid16269694 \rtlch\fcs1 \af1\afs24\alang1025 \ltrch\fcs0 \f1\fs24\cf1\lang4105\langfe4105\cgrid\langnp4105\langfenp4105 {\rtlch\fcs1 \af1\afs20 \ltrch\fcs0 \fs20\cf0\insrsid2777835\charrsid10884349 Assistant Commissioner/Regional Deputy Commissioner Signature (or representative) \~: \cell }\pard \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\pararsid15286331 {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \f41\fs16\cf0\insrsid15286331\charrsid10884349 Name in script letters:}{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \f41\fs16\cf0\insrsid2753292\charrsid10884349 \par }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid15286331\charrsid10884349 \par \cell }\pard \ltrpar\s15\ql \li0\ri0\widctlpar\intbl\wrapdefault\faauto\rin0\lin0\pararsid12340144 {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \f41\fs16\cf0\insrsid12340144\charrsid10884349 Signature\~}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \f41\fs20\cf0\insrsid12340144\charrsid10884349 : \par }\pard \ltrpar\s15\ql 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