ﺔﻴﺒﻌﺸﻟا ﺔﻴﻃاﺮﻘﻤﻳﺪﻟا ﺔﻳﺮﺋاﺰﺠﻟا ﺔﻳرﻮﻬﻤﺠﻟا
ﻲﻟﺎﻌﻟا ﻢﻴﻠﻌﺘﻟا ةرازو ﻲﻤﻠﻌﻟا ﺚﺤﺒﻟاو
ﺔﻌﻣﺎﺟ ﺤﻳﻲ سرﺎﻓ ﺔﻳﺪﻤﻟﺎﺑ
ةرﺎﻤﺘﺳا ﺐﻠﻃﺔﻨﺴﻟا ﺪﻴﻤﺠﺗ
..... : ﺐﻟﺎﻄﻟا ،ﻪﻠﻔﺳأ ﻲﻀﻤﻤﻟا ﺎﻧأ...............................................................
....... : ﺦﻳرﺎﺘﺑ دﻮﻟﻮﻤﻟا............................ﺑ .ـــ.. : ـ......................................
...................................... : ﺔﻴﻠﻜﺑ ﻞﺠﺴﻤﻟا..........................................
ﻲﻓ.......................... : ﺺﺼﺨﺗ.........................................................
ﺔﻨﺴﻟا ﻲﻓ :............................. ﺖﺤﺗﻞﻴﺠﺴﺘﻟا ﻢﻗر ........... :.........................
ﺔﻴﻌﻣﺎﺠﻟا ﺔﻨﺴﻟا ﺪﻴﻤﺠﺗ ﺐﻠﻃأ.....20/.....20 : ﺔﻴﻟﺎﺘﻟا بﺎﺒﺳﻸﻟ
ﻣﻦﻣﺰﻣ ضﺮ.
ﺔﻣﻮﻣأ ﺔﻠﻄﻋ.
ﺔﻠﻳﻮﻃ ةﺪﻤﻟ ضﺮﻣ.
ﺔﻴﻨﻃﻮﻟا ﺔﻣﺪﺨﻟا.
أ لﻮﺻﻷﺎﺑ ﺔﻘﻠﻌﺘﻣ) ﺔﻴﻠﺋﺎﻋ تﺎﻣاﺰﺘﻟا ﻞﻳﻮﺤﺗ ،عوﺮﻔﻟا و نﺎﻜﻣءﺎﺑﻵا وأ جوﺰﻟا ﻞﻤﻋ...(.
ىﺮﺧأ بﺎﺒﺳأ ............. :.............................................................
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ﻈﺣﻼﻣتﺎ :
- ﺐﺠﻳ ﻢﻳﺪﻘﺗﻒﻠﻣ ﻹ ﺔﻘﻴﺛو وأﺛﺒﺎﺪﻴﻤﺠﺘﻟا ﺐﺒﺳ ت.
- ﺘﻳ عاﺪﻳإ ﻢةرﺎﻤﺘﺳﻻا ﻩﺬﻫ ﺎﻬﺌﻠﻣ ﺪﻌﺑ ﻒﻠﻤﻟا ﻊﻣ .ﺔﻴﻠﻜﻟا ىﻮﺘﺴﻣ ﻰﻠﻋ
: ءﺎﻀﻣﻹا
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