Ø§Ù„ØªØ³Ø¬ÙŠÙ„ Ø¥Ù†Ø´Ù‰ ØØ³Ø§Ø¨ Ù…Ø¹Ù†Ø§

Ù‡Ù„ Ù‚Ù…Øª Ø¨Ø§Ù„ØªØ³Ø¬ÙŠÙ„ Ù…Ù† Ù‚Ø¨Ù„ ØŸ

Ù‡Ù„ Ø³Ø¬Ù„Øª Ù…Ù† Ù‚Ø¨Ù„ ØŸ Ø¥Ø°Ø§ Ù†Ø¹Ù…ØŒ ÙŠØ±Ø¬Ù‰ Ø§Ù„Ø¶ØºØ· Ø¹Ù„Ù‰ Ø§Ù„Ø²Ø± Ø§Ø¯Ù†Ø§Ù‡ Ù„ØªØ³Ø¬ÙŠÙ„ Ø§Ù„Ø¯Ø®ÙˆÙ„ Ù„Ù…Ù†Ø·Ù‚Ø© Ø§Ù„Ø¹Ù…ÙŠÙ„ Ù„ØªØ³ØªØ·ÙŠØ¹ Ø§Ù„ØªØÙƒÙ… Ø¨ØØ³Ø§Ø¨Ùƒ.

Ø¥Ø¹Ø§Ø¯Ø© ØªØ¹ÙŠÙŠÙ† ÙƒÙ„Ù…Ø© Ø§Ù„Ù…Ø±ÙˆØ±

Ø§Ù„Ù…Ø¹Ù„ÙˆÙ…Ø§Øª Ø§Ù„Ø´Ø®ØµÙŠØ©

Ø¹Ù†ÙˆØ§Ù† Ø§Ù„ÙÙˆØ§ØªÙŠØ±

Ø§Ù„Ù…Ø¹Ù„ÙˆÙ…Ø§Øª Ø§Ù„Ø¥Ø¶Ø§ÙÙŠØ©
(Ø§Ù„ØÙ‚ÙˆÙ„ Ø§Ù„Ù…Ø·Ù„ÙˆØ¨Ø© ØªØÙ…Ù„ Ø¹Ù„Ø§Ù…Ø© *)

Cell Phone

Home Phone

Fax

Backup Email Address

Instant Messenger Type

Instant Messenger ID

Ø£Ù…Ø§Ù† Ø§Ù„ØØ³Ø§Ø¨

Ù„Ù…Ø§Ø°Ø§ Ø§Ù„Ø³Ø¤Ø§Ù„ Ø§Ù„Ø³Ø±ÙŠØŸ

ÙˆØ¶Ø¹ Ø³Ø¤Ø§Ù„ Ø£Ù…Ø§Ù† Ù„ØªÙˆÙÙŠØ± Ù…Ø²ÙŠØ¯ Ù…Ù† Ø§Ù„Ø£Ù…Ø§Ù†ØŒ ØÙŠØ« Ø£Ù† Ø¬Ù…ÙŠØ¹ Ø§Ù„ØªØºÙŠÙŠØ±Ø§Øª ÙÙŠ ØØ³Ø§Ø¨Ùƒ ØªØªØ·Ù„Ø¨ ØªÙˆÙÙŠØ± Ù…Ø¹Ù„ÙˆÙ…Ø§Øª Ø¥Ø¶Ø§ÙÙŠØ© Ø¹Ù† Ø³Ø¤Ø§Ù„Ùƒ.

Ø§Ù„ØªØ³Ø¬ÙŠÙ„ Ø¥Ù†Ø´Ù‰ Ø­Ø³Ø§Ø¨ Ù…Ø¹Ù†Ø§

Ù‡Ù„ Ù‚Ù…Øª Ø¨Ø§Ù„ØªØ³Ø¬ÙŠÙ„ Ù…Ù† Ù‚Ø¨Ù„ ØŸ

Ø¥ØªÙØ§Ù‚ÙŠØ© Ø§Ù„Ø®Ø¯Ù…Ø©

Ù„Ù…Ø§Ø°Ø§ Ø§Ù„Ø³Ø¤Ø§Ù„ Ø§Ù„Ø³Ø±ÙŠØŸ

Ø¥Ù†Ø´Ø§Ø¡ ÙƒÙ„Ù…Ø© Ù…Ø±ÙˆØ±

Ø§Ù„ØªØ³Ø¬ÙŠÙ„ Ø¥Ù†Ø´Ù‰ ØØ³Ø§Ø¨ Ù…Ø¹Ù†Ø§

Ø¥ØªÙØ§Ù‚ÙŠØ© Ø§Ù„Ø®Ø¯Ù…Ø©