zilongwang/ReadingBank huggingface dataset:
BRANCH INFORMATION SHEET BRANCH : ……………………………………………………….DATED:…………………………………………. 1. DETAILS OF BRANCH OFFICIALS Appointment, Name & Service No. Address & Post Code Contact Details Honorary Secretary Tel: Email: Title Surname Known Name Initials Army No: Honorary Treasurer Tel: Email: Title Surname Known Name Initials Army No: Chairman Tel: Email: Title Surname Known Name Initials Army No: President Tel: Email: Title Surname Known Name Initials Army No:
Appointment, Name & Service No. Address & Post Code Contact Details Standard Bearer Tel: Email: Title Surname Known Name Initials Army No: 2. DETAILS OF BRANCH MEETINGS a. Location of meetings b. Day of meeting (ie 1st Mon of month) c. Time of start of meetings d. Average attendance at meetings
Country: Eircode / Postcode: Telephone: Mobile: Email: Fax (0ptional): Name of Senior Contact Person (if known): PART B: Payment dispute details Does the payment dispute arise under a construction contract as defined in the Construction Contracts Act, 2013? Yes No State the Payment Claim Date for the amount in dispute: State the amount in dispute (even if the amount is zero): € State the amount in words: Describe the payment dispute from the following options: Failure to make an interim payment Failure to make a final payment Other payment dispute (please specify) Continue on separate sheet if needed Provide any additional information considered relevant to the payment dispute:
2.2 Please state here the other activities and services stated by the respondents. School Library Activities and Services School Levels Other Library Activities Other Library Services Elem Schools 1. 2. 3. 1. 2. 3. Junior HS 1. 2. 3. 1. 2. 3. With Senior High 1. 2. 3. 1. 2. 2 Stand Alone Senior High Schools 1. 2. 3. 1. 2. 3. 4. COLLECTION MANAGEMENT 4.2.1 Based on responses, please specify below the other broad subjects and its scope, subjects that are not in the given categories. 4.2.1 GENERAL REFERENCES Copyright 2005-Present Copyright Earlier TOTAL Broad Subjects Scope No. of Titles No. of Copies No. of Titles No. of Copies No. of Titles No. of Copies TOTAL 4.2.2 Based on responses, please specify below the other broad subjects and its scope, subjects that are not in the given categories. 4.2.2 GENERAL COLLECTION (Subject Area Specific References) Copyright 2005-Present Copyright Earlier TOTAL Broad Subjects Scope No. of Titles No. of Copies No. of Titles No. of Copies No. of Titles No. of Copies TOTAL
4.2.3 Please specify below the other subjects that were answered by the respondents. 4.2.3 ADDITIONAL SUPPLEMENTARY READERS Copyright Copyright 2004-or Ealier Combined Total Number of Titles No. of Titles No. of Copies No. of Titles No. of Copies TOTAL 4.2.4 Please specify below the other non-print collection that were answered by the respondents. 4.2.4 NON-PRINT COLLECTION Copyright Copyright 2004-or Earlier Combined Total Number of Titles Total No. of Titles TOTAL 5. ACQUISITION 5.1 Other School Library Means for Books Acquisition 5.2 Other Sources of School Library budget 6. FACILITIES 6.1 Other ICT Facilities
SCHEDULE OF MAINTENANCE – PRESCRIBED ESSENTIAL BUILDING SERVICES Section 206 Regulation 72 For: Building description Address Suburb/postcode Building Surveyor details: Building Surveyor: Category: BS BSL Address: Phone No: Fax No: Licence No: Email address: PART 1 Details of essential building services: Regulation 72 of the Building Regulations 2016 requires that the following essential building services are to be maintained. (Delete those not applicable and list the specific features or measures where provided for) “NCC” refers to National Construction Code provisions in Volume One (building features or measures) or Volume Three (plumbing features). Table 1.1 BUILDING FIRE INTEGRITY Frequency of testing or inspection specified by the Director of Building Control: Feature NCC provisions for determining standard of performance Building elements required to satisfy prescribed fire-resistance levels Section C, D1.12 As prescribed in AS 1851 - 2012. Materials and assemblies required to have fire hazard properties C1.10 As prescribed in AS 1851 - 2012. Elements required to be provide fire protection, compartmentation or separation C2.5 to C2.14, C3.3, C3.11, D1.7, D1.8, E1.3, G3.4 As prescribed in AS 1851 - 2012. Wall-wetting sprinklers (including doors and windows required in conjunction with wall-wetting sprinklers) C3.4, C3.8, C3.11, D1.7, D1.8, G3.8 As prescribed in AS 1851 - 2012. Fire doors (including sliding fire doors and their associated warning systems) and associated automatic closing and latching mechanisms C2.12, C2.13, C3.4 to C3.8, C3.10, C3.11, D1.7, D1.8, D1.12 As prescribed in AS 1851 - 2012. Fire windows (including windows that are automatic or permanently fixed in the closed position) C3.4, C3.8, C3.11, D1.7 to D1.8 As prescribed in AS 1851 - 2012. Fire shutters C3.4, C3.5, D1.7, D1.8 As prescribed in AS 1851 – 2012. Solid core doors and associated self-closing, automatic closing and latching mechanisms C3.11 As prescribed in AS 1851 - 2012.
(Please continue on a separate sheet) Mitigation If an existing solid fuel burner is being removed or replaced to provide an offset for a new woodburner please provide the following information for the solid fuel burner that will be removed or replaced: Manufacturer Appliance (brand e.g. Kent) Specify if the appliance is a wet-back Yes No Date of installation (if applicable) Appliance type (as defined in PC13): woodburner coal burner or multifuel burner indoor open fire other solid fuel burner (e.g. coal range, chip heater) please specify Fuel type (wood, coal Emission rate (g/kg) Thermal efficiency (%) Rotorua Lakes Council building consent number (if applicable) Environment Canterbury or Nelson City Council authorisation number For authorisation number please see: Statutory Assessment This policy assessment is required as per s88 and schedule 4 of the RMA for the application to be considered completed. This policy assessment is required as per s88 and schedule 4 of the RMA for the application to be considered completed.
--- Evaluation ends here. --- Thank you very much for your time and effort in filling-out this form. Your honest and objective evaluation will greatly contribute to our effort in helping your organization become better and be more effective. Please return accomplished form to your organization. The rating generated through this survey will be used for this year’s Magis Awards. Note: This evaluation system uses multiple perspectives in assessing the efficacy of student organizations on campus. The following are the five components comprising this system: A. Organization Officers B. Organization Members C. CSG/ College Councils D. Moderator E. RRC Student organizations are evaluated based on three areas: 1. Organizational Development (30%) 2. Student Welfare (30%) 3. Involvement in the Community (40%) The partial rating for each area is derived by dividing the raw score earned by the organization and the possible perfect score. The quotient is multiplied by 100 in order to get the percentage. The product is further multiplied by the weight assigned for the particular area. To get the final rating, the partial ratings generated for each area are being added. --- This evaluation system is developed by the Review and Recognition Committee (RRC) AY 2008-2009 and revised by the same committee, AY 2012-2013. Use or adaptation of this tool is not allowed unless permission is granted by SACDEV-OSA. Interpretation of Rating: Level 5 (95% - 100%) - Exemplary The organization performs tasks/ meets conditions reflecting highest level of performance; very consistent, commendable, and effective. 4 (90% - 94%) - Advanced The organization performs tasks/ meets conditions reflecting mastery of performance with minimal supervision required. 3 (75% - 89%) - Improved The organization performs tasks/ meets conditions reflecting development towards mastery of performance with occasional supervision required. 2 (61% - 74%) - Basic The organization performs tasks/ meets conditions reflecting beginning level of performance; tasks/ conditions not met satisfactorily most of the time; demonstrates understanding of the tasks/ conditions involved. 1 (60% and below) - Deficient The organization is not able to satisfactorily meet the conditions required.
*Address of applicant: [repeat for more applicants] address *make oath and say/*do solemnly and sincerely declare and affirm: The deceased died at suburb or town in state on 00/00/0000. [If the date of death is between two dates please state “the deceased was last seen alive on 00/00/0000 and their body found on 00/00/0000”] The Record of Death annexed to this affidavit and marked “A” is an original extract of the Record of Death of the deceased. The deceased left an estate in Tasmania. The document/s* exhibited to this affidavit *is/*are the true and original last valid Will [insert details of any codicil or any other testamentary disposition forming part of the Will] of the deceased. The Will is dated 00/00/0000. The details of each subscribing witness to the Will are as follows: The deceased was aged 00 at the date of execution of the Will and 00 at the date of death. [if the deceased was less than 18 years of age at the date of execution of the Will or at the date of death then make such statements and annex such materials as required by rule 44] No further explanation or clarification of the validity of the Will is necessary. [if further explanation or clarification of the validity of the Will or any part of the Will is required (including under rules 43, 45, 46, 47, 48, 49, 50, 51, 52, 53 and 54) then make any statements and annex any materials relevant in the circumstances, for example: an affidavit of due execution or an order of the Court] The Will of the deceased has not been revoked. The deceased was: [select all those which apply] *single
BE NOTIFIED FURTHER: All objections to the Petition must be in writing, setting forth the grounds of any such objections. All objections should be sworn to before a notary public or before a Probate Court Clerk, and filing fees must be tendered with your objections, unless you qualify to file as an indigent party. Contact Probate Court personnel for the required amount of filing fees. If any objections are filed, a hearing will be scheduled at a later date. If no objections are filed, the Petition may be granted without a hearing. Sarah S. Harris____________________ PROBATE JUDGE By: ________________________________ PROBATE CLERK/DEPUTY CLERK Probate Court of Bibb County P.O. Box 6518 Macon, GA 31208-6518 (478) 621-6494
HEATING APPLIANCE* INSTALLATION COMPLIANCE CERTIFICATE Regulation 30 (* A stove, heater or similar appliance that burns oil or solid fuel) To: Permit Authority Address Suburb/postcode Details of installation: Address: (address of installation) (X the applicable box.) new: second-hand: replacement: freestanding: built-in: flue only: Appliance type: fuel used: Make: model No.: (X the applicable box.) Manufacturer: AS 2918- tested: yes: no: Address: compliance cert. No. emission cert. No. Flue type: hearth type: Owner/installer details: Owner: Contact person: Address: Phone No: Fax No: Email address: Installer: Address: Phone No: Fax No: Registration No. (if applicable): Email address: Notification and Certification details: I certify that the installation of the heating appliance referred to above, has been carried out in accordance with the National Construction Code. Note: this notification must be supplied to the Permit Authority within 7 days of the installation. (Delete one not applicable) Name: [print] Signed Date Owner/Installer:
Service Upon Minor or Adult Ward through Service Upon Guardian INSTRUCTIONS I. Specific Instructions This form is to be used when serving a minor or adult ward pursuant to O.C.G.A. It will be inserted by the court at the appropriate place in the underlying proceedings. With respect to service upon an adult ward, this form should only be used after the person has been adjudicated to be an incapacitated adult. When this form is used, Uniform Probate Court Rule 5.6 (D) applies. It provides, “Unless the court specifically assumes the responsibility, it is the responsibility of the moving party, in connection with any citation which must be served by mail, including without limitation a citation concerning an application for year’s support, to provide to the court a properly stamped envelope, addressed to each interested party, with the return address of the probate court appearing thereon.” II. General Instructions General instructions applicable to all Georgia probate court standard forms are available in each probate court.
Act, Sec. 60 PAPUA NEW GUINEA Form 6 Reg., Sec.14 (TRADE MARKS 1978 (CHAPTER 385) APPLICATION FOR RENEWAL OF REGISTRATION OF TRADE MARK FOR OFFICIAL USE PAYMENT BY BANK DRAFT OR CHEQUE ACCEPTED FEE: ITEM 14 Here insert the full name of the individual, firm or body corporate making application If a body Application is hereby made by (a) corporate, firm or analogous body is making application, indicate the state or country of incorporation of registration. The names of all parties in a firm must be given in full. Here insert the full trade or business address of the applicant. whose trade or business address is (b) Here insert the number of the Registered trade Mark. for renewal of registered Trade mark No: (c) Here insert the date of the Registered Trade Mark. dated (d)
CERTIFICATE OF GUARDIANSHIP / CONSERVATORSHIP TERMINATED Make Electronic Submissions via the Georgia Criminal Justice Information System (CJIS) Network -OR- forms to: Georgia Crime Information Center Attention: Georgia Crime Information Center Attention: CJIS Operations Unit 3121 Panthersville Rd. Decatur, Georgia 30034 *DATE OF ORDER (mm/dd/yyyy) *JUDGE’S NAME *PROBATE COURT COUNTY/ORI NUMBER *ESTATE NUMBER THE FOLLOWING INDIVIDUAL HAS BEEN ADJUDICATED TO LACK SUFFICIENT MENTAL CAPACITY AND GUARDIANSHIP/CONSERVATORSHIP HAS BEEN ESTABLISHED. THE ORDER REFERENCED ABOVE TERMINATES SUCH APPOINTMENT. *NAME (Last, First, Middle) *SEX *RACE *DATE OF BIRTH (mm/dd/yyyy) SOCIAL SECURITY NUMBER (###-##-####) CURRENT ADDRESS (Street Address) CITY STATE ZIP CODE SIGNATURE (Court Official) DATE SIGNED *Court Official’s Title *Mandatory Field
Faculty Member Name Rank Tenure Status Department College Personnel Number APPR Rating Needs Improvement for Rank Relevant area(s) of concern for this plan (check all applicable) Teaching Scholarly Activities Unsatisfactory for Rank Date of the annual review triggering this plan Service Patient Care Planned ongoing quarterly assessments (month/year) Final Assessment and Evaluation #1 #2 #3 month year Description of Specific Performance Concern Specific Performance, Results &/or Outcomes to be Achieved to Address Concern Activities, Resources &/or Actions to Accomplish Outcomes (2) Metrics to Assess Ongoing Progress Metrics to Evaluate Achievement Met or Not Met + Date 1. 2. 3. 4. Notes: (1) Add more rows if needed (2) Additional narrative should be included on an attached page (3) Attach APPR that triggered plan. Initial Plan Development Final Review of Plan Faculty Member Signature Date Faculty Member Signature Date Department Chair Signature Date Department Chair Signature Date Dean Signature Date Dean Signature Date
MEDICAL EXAMINATION Date of examination Applicant’s Date of Birth Height Weight Blood Pressure ABNORMAL COMMENTS Eyes Ears Nose,Throat Heart, Lungs Abdomen Extremities Neurological Hernia Check Allergies to Medicine: YES NO If yes, please list: Restrictions Physician’s Name (print) Address City/State/Zip Phone Physician’s Signature Parent/Guardian (NAME): Phone: H ADDRESS: CITY B STATE ZIP (*Examination must not have been given more than 90 days prior to activity. Date(s) of activity is/are ) Emergency Contact if parent/guardian not available: Name: Address State Zip Phone H B Name Address State Zip Phone H B Family Doctor: Name Phone ADDRESS: CITY STATE ZIP Medical Insurance Policy Name Policy # To be answered by parent or guardian (Check one) DOES YOUR CHID HAVE OR EVER HAD: 1. Sickle Cell Anemia? ………………………... NO YES 2. Food medication allergy? ………………….. NO YES 3. Epilepsy, seizures, fainting spells? …………. NO YES 4. Heat Stroke or heat exhaustion? ……………. NO YES 5. Diabetes mellitus (sugar)? …………………. NO YES 6. Hemophilia (bleeding disorder)? ……………. NO YES 7. Bone or joint problem? …………………….. NO YES 8. Heart Problem? ……………………………… NO YES 9. Hearing or vision problems? ………………. NO YES 10. Eye glasses, contact lenses? ………………. NO YES 11. Dentures or hearing aid? …………………. NO YES 12. Loses of function of a body part? ……………. NO YES 13. Require a special diet? …………………….. NO YES 14. Special psychiatric needs? ………………….. NO YES 15. High blood pressure, hypertension? …………. NO YES If the answer to any of the above questions is “yes”, explain fully below. Give details as to when the event occurred, your child’s current status, and any special needs that he now has. Medications: NAME EXACT DOSAGE SPECIFIC TIME GIVEN 1.
1.3 Previous Appointments (most recent first) Dates Position Institution/Employer 1.4 Qualifications, Awards, Memberships (most recent first) Year Qualification Institution (if relevant) Academic Qualifications Year Description Awards, incl. Fellowships Year Description Memberships FOLIO 2 – Teaching This Folio should be completed by Teaching Focused, Teaching and Research Academics and Clinical Academics. Research Focused academics should complete the sections that relate to postgraduate supervision (2.4 – 2.5) and where there is undergraduate teaching involvement, sections 2.1 – 2.3. The may be referred to when completing this section. 2.1 Formal Teaching Contact: Under- and Post-Graduate (excluding contact in flexible delivery/distance/intensive/clinical mode) Fill in actual hours spent in scheduled award-related teaching (list most recent first). For each semester, include a ‘Total’ line, summing the total contact hours across all courses for that semester. Year/ Semester Course Code & Name Credit Your total formal classroom contact hours in this course per semester. Do not include preparation time. Notes – Indicate the class size. Show contact hours by teaching mode (lecture, seminar, tutorial, practical, laboratory, clinical, other). If you team teach, list role (eg coordinator, lecturer, tutor) and percentage contribution. 2.2 Formal Teaching Contact: Flexible Delivery/Distance/Intensive and Clinical Year/ Semester Course Code & Name Credit Explain your time commitment and provide your total hours per semester. Do not include preparation time. Notes - Include relevant data on class size and predominant mode of teaching. List your role (eg course developer, coordinator, lecturer, tutor) and percentage contribution. 2.3 Evaluation(s) of Teaching Applicants for Mid-Term review, Final Review for Continuing Appointment and Promotion (not required, however, encouraged for Research Focused where teaching is undertaken) must include their UQ approved independent summary sheets of teaching evaluations (TEVALs, SECaTs). This should include all courses to which a substantial teaching contribution was made over at least the three most recent semesters. Indicate reasons for the absence of the required number under the title of the course below.
Section III–Project Budget III.1. Complete and attach the Budget Summary Plan (Form F). III.2. Complete a Budget Narrative. Provide a detailed justification for each line item cost contained in the Budget Summary Plan (Form F). Explanations should include how the proposed costs are necessary and reasonable. The proposed budget is designed to fund, at minimum levels needed for quality service provision, the services, training, and support required to develop and implement the program as described in the narrative above. Salaries: (Total Salaries Paid - WIOA 15%) $_________ For a benefits rate that varies among staff members, please use the format below: Position FTE x Salaries x time Benefits Total (salary + benefits) Sample - Program Manager .5 FTE x $4,500 x 12 months 24.6% $33,642 For a benefits rate that is the same for all staff, please use the format below: Position FTE x Salaries x time Total (salary + __% benefits rate) Sample - Program Manager .5 FTE x $45,000 x 12 months $33,642 Staff Travel $_________ List staff traveling, destination, and mode of transportation. Operating Expenses $_________ (Not to exceed 10 percent of the award) The following are some of the major line items included
Contractual Services $_________ Description of the services provided by each contractor, cost of individual contract, name of organization/individual providing services. If the contract is out for proposal, list type of procurement and the date the contract will be awarded. Upon award, a revised Exhibit G, Supplemental Budget, must be submitted to EDD. Other $_________ Clearly explain what these costs encompass that does not fit into the specific categories above.
Incident written notification within 5 days of incident ending Licensee under the Water Industry Competition Act 2006 must report an incident via email within 5 days of the incident ending Email must contain the word “incident” in the subject line CONTACT DETAILS From Licensee business name Licence number Contact Person in charge of dealing with the incident Name: Position Phone: Email: To Local Public Health Unit in NSW Health (in accordance with the incident and emergency response protocol). Department of Planning and Environment colette.grigg@planning.nsw.gov.au IPART Copy Water Unit in NSW Health RECORD OF IMMEDIATE VERBAL NOTIFICATION Stakeholder Time/ Date Person contacted (indicate if message was left with the contact) Local Public Health Unit Phone number outlined in Incident and Emergency Response Protocol Department of Planning and Environment (02) 8275 1914 IPART (02) 9113 7722 Other agencies or persons notified (provide name and contract details) EPA Local Council Emergency Services (please indicate which one) Other licensees and/or public water utilities Others
Sport Principal Consent Form I hereby certify that the following student: Name Date of Birth who has been selected to compete in the __________________________ Championships to be held in ______________________ from _____________________to ______________________ is enrolled as full-time student of this school. I further declare that the student’s record of attendance and conduct are such that I have no hesitation in recommending and approving the athlete’s selection in the team. Date of Birth as listed corresponds with school records. I hereby consent to the student’s participation in the team. Principal’s Signature: ___________________________________ School: ___________________________________ Date: ___________________________________ SCHOOL STAMP PLEASE RETURN TO THE TEAM MANAGER AS LISTED IN THE TEAM INFORMATION LETTER. Updated 19 January 2016
Degree Program Name Academic Year Department Name School Name Dixie State University PLO Identify the PLO(s) assessed in the current AY (1-2) Measure(s) Direct or indirect Description of measure (upload instrument & sample artifacts) Scoring strategy (upload rubric) Score scale (e.g., 4=exemplary, … 1=unacceptable) Baseline / Threshold / Benchmark/ Target Data Collection Method Course(s) number Semester collected Sample size Results For each PLO, consider all the data and summarize the three important findings Highlight whether the targets were met, partially met, or not met Include summary reliability indices Action Taken (closing the loop) State action(s) taken to improve student learning Direct Measure(s): Indirect Measure(s): Direct Measure(s): Indirect Measure(s):
1. Your personal details TITLE Please tick Mr Mrs Miss Ms Other (please state) Surname Forenames PREVIOUS NAMES (if relevant) please enter details of any previous names or maiden names. Please continue on a separate sheet if necessary. TITLE Please tick Mr Mrs Miss Ms Other (please state) Surname Forenames Date of Birth Nationality I am 18 years old or over. Please tick Yes No ADDRESS WHERE ORDINARILY RESIDENT (We will use this address to correspond with you unless you complete the separate correspondence box below). Post town Post code TELEPHONE NUMBERS Daytime Evening Mobile FAX NUMBER E-MAIL ADDRESS (if you would prefer us to correspond with you by e-mail)
Address for correspondence associated with this application (if different to the address above) Post town Post code TELEPHONE NUMBERS Daytime Evening Mobile E-MAIL ADDRESS (if you would prefer us to correspond with you by e-mail) 2. Your licensing qualifications Read Note 1 Please tick yes Please indicate below which one of these statements applies to you: 1. I hold an accredited licensing qualification 2. I hold a certified qualification 3. I hold an equivalent qualification 4. I am a person of prescribed description If you have ticked either of statements 1, 2 or 3 please provide details of your qualification in the box below (name of qualification, date of issue, issuing body) and please enclose your qualification with your application. If you have ticked statement 4, please provide evidence that you are a person of prescribed description. 3. Previous or outstanding applications for a personal licence Note: You may only hold one personal licence at a time. Please tick Do you currently hold a personal licence? Yes No Do you currently have any outstanding applications for a personal licence, with this or any other licensing authority? Yes No
FORM C: CONTACT PERSON INFORMATION FORM Legal Name of Applicant: This form provides information about the appropriate contacts in the Applicant’s organization in addition to those on the FACE PAGE. If any of the following information changes during the term of the contract, please send written notification to the Contract Management Unit. Contact: Mailing Address (incl. street, city, county, state, & zip): Title: Phone: Ext. Fax: E-mail: Contact: Mailing Address (incl. street, city, county, state, & zip): Title: Phone: Ext. Fax: E-mail: Contact: Mailing Address (incl. street, city, county, state, & zip): Title: Phone: Ext. Fax: E-mail: Contact: Mailing Address (incl. street, city, county, state, & zip): Title: Phone: Ext. Fax: E-mail: Contact: Mailing Address (incl. street, city, county, state, & zip): Title: Phone: Ext. Fax: E-mail:
COMPOSITE DISTRICT All Hallows’ School Anglican Church Grammar School Brisbane SHS Cannon Hill Anglican College Iona College Loreto College Lourdes Hill College Moreton Bay College Moreton Bay Boys College Our Lady’s College San Sisto College Somerville House St Laurence’s College Villanova College LOGAN DISTRICT Groves Christian College John Paul College Kingston College Loganlea SHS Mabel Park SHS Marsden SHS Redeemer Lutheran College Springwood SHS Woodridge SHS SOUTH DISTRICT Balmoral SHS Brisbane Adventist College Cavendish Road SHS Citipointe Christian College Clairvaux Mackillop College Coorparoo Secondary College Holland Park SHS Mansfield SHS Mount Gravatt SHS Nursery Road Special School Rochedale SHS Seton College St James College Whites Hill State College 2015 Metropolitan East Region – District 10 to 12yrs BAYSIDE DISTRICT Alexandra Hills SS Bay View SS Birkdale SS Birkdale South SS Macleay Island SS Manly SS Manly West SS Mount Cotton SS St John Vianney’s School St Luke’s School St Mary MacKillop Primary St Rita’s School 12 Yr Olds High School Feed In Alexandra Hills SHS Brisbane Bayside State College Carmel College
DISTRICT Citipointe Christian College Dutton Park SS Greenslopes SS Holland Park SS Junction Park SS MacGregor SS Mackenzie SS Mansfield SS Mount Gravatt East SS Mount Gravatt SS Nursery Road Special School Rochedale SS Seville Road SS Somerville House St Agnes’ School St Bernard’s School St Ita’s School St Joachim’s School St Laurence’s College Upper Mount Gravatt SS Wellers Hill SS West End SS Wishart SS Brisbane SHS Cavendish Road SHS Citipointe Christian College Clairvaux Mackillop College Holland Park SHS Mansfield SHS Mount Gravatt SHS Our Lady’s College Rochedale SHS Seton College Somerville House St James College St Laurence’s College
Successors and Assigns. This Agreement shall be binding upon the Parties hereto and their successors and assigns. Governing Law. This Agreement shall be governed by and construed in accordance with the laws of the State of Utah. Counterparts. This Agreement may be executed in several counterparts, all or any of which may be treated for all purposes as an original and shall constitute and be one and the same instrument.
CABINET COMMENT FORM Submission Title: Agenda Number: Minister: Portfolio: COMMENT BY: Department/Agency/Minister Was your agency/Minister’s office consulted in the preparation of this submission? Yes / No Does your agency/Minister’s office support the recommendations of this submission? Yes / No If your agency/Minister’s office does not support this submission, detail the key issues you would like Cabinet to consider in its deliberations Prepared by: Telephone: Approved: Chief Executive/Chief of Staff (or delegate): Date:
Where will the Community Program / Event take place? Please provide a site plan / map. The Program / Event / Festival must be within the boundaries of the City of Adelaide. Please indicate the exact location for each element. Will the Community Program / Event incorporate any environmentally sustainable practices? (e.g. 10 x water fountains for drink bottle re-filling will be made available to workshop participants at each workshop. 100 x A3 posters only will be printed using 100% recycled paper.) What are the estimated fees and charges imposed by the Adelaide City Council for this Community Program / Event? Please refer to Attachment A “Contacts and Costing Details for Council Services” for further
Form Administrative Rule 9-G1 STATE OF INDIANA IN THE _____________ COURT, COUNTY OF________ _____________________, ) Plaintiff(s), ) ) Case No: ____________________ vs. ) ) _____________________, ) Defendant(s) ) Administrative Rule 9(G)(5) Notice of Exclusion of Confidential Information from Public Access (FILED WITH TRIAL COURT CLERK) Contemporaneous with the filing of this notice, [party name] has filed confidential information on green paper in accordance with Administrative Rule 9(G)(6). Pursuant to Administrative Rule 9(G)(5), [party name], provides this notice that the confidential information contained on that green paper is to remain excluded from public access in accordance with the authority listed below: Name or description of document filed on green paper. [List here] Administrative Rule 9(G) grounds upon which exclusion is authorized. [List 9(G) grounds here.] [NOTE: If 9(G)(2)(a), 9(G)(2)(b) or 9(G)(3)(b) provides the basis for exclusion, you must also list the specific law, statute, or rule declaring the information confidential.] Respectfully submitted, ___________________________________ [Insert Name]
Full or Partial Transfer (Note: Cross one checkbox only.) PART 7 Full or Partial Transfer* (for Trade Marks only) Note : If "Partial" is indicated, provide details of the trade mark no., class no. and goods and/or services for which the transfer is to be recorded at Annex A. The transfer application may only be for goods and/or services already covered in the trade mark application/registration, not for those falling outside. Full or Partial Transfer (Note: Cross one checkbox only.) PART 8 Date of Transfer of Ownership* Date of Transfer of Ownership* (DD/MM/YYYY) PART 9 Other Details Details of Transfer of Ownership to be Registered (e.g. Type of Transfer, Percentage/Extent of Interest being Transferred) PART 10 Contact Details* Note: Where an agent with UEN is appointed, the fields for “Representation Type”, "Agent UEN/ Company Code", "Agent Name" and "Address for Service in Singapore" should be completed. For non-agent individual or entities, the sub-fields “Representative or C/O Name” and "Address for Service in Singapore" should be completed instead. For Agents: Select Option A if you are appointed as the agent to receive official correspondence pertaining to all matters (including renewal, if applicable) relating to application, registration or grant, except those matters expressly excluded on the Register. Otherwise, select Option B if you are only representing the interested parties for transfer of ownership only and not for other matters. For Non-Agents: Select Option A if you wish to receive all official correspondence for all matters (including renewal, if applicable) relating to application, registration or grant, except those matters expressly excluded on the Register, following the approval of this recordal of the transfer of ownership. Otherwise, select Option B if you wish to receive official correspondence pertaining only to this recordal of transfer of ownership. Complete Annex B if Option B is selected. The Address for Service as indicated in this part will be for the following matter:
Consider whether the planned program is suitable for those students with special needs who are attending. Environmental Venue Physical survey of the grounds (walk around) Ensure that spectators and vehicles are kept clear of the competition and warm up areas. Check the site for hazards, and implement controls as necessary. Grounds correctly marked and correct equipment provided Protective padding in place (if applicable) Adequate dressing sheds and number of toilets; daily cleaning provided Adequate safe seating, shade/shelter for spectators and participants Suitable catering and provision of water facilities Adequate PA system – able to be heard throughout the venue Sun safety Adopt sun-safe strategies. For example: ensure that shaded areas, hats, sun-smart clothing and sunscreen are used. Hydration Ensure that drinking water is readily available. (Students should not share drinking containers.) Weather conditions (e.g. storms, wind) Monitor weather conditions and have contingency plans. Vehicles Safe and suitable parking, and pick-up areas Establish safe, designated areas for people and vehicles. Accommodation
How could it have been handled differently? What action needs to be taken as a result of this ‘incident’? What lessons can be learnt for future reference? Registrar Signature: Date: Supervisor Signature: Date: Review of incident by Regional Head of Education and Director of Medical Education and Training. List the outcomes and actions arising from the review of this ‘incident’. DMET Signature: Or RHE Date: Please email completed form to your region below: Metro West: North West: North East: South West: FOR OFFICE USE ONLY: This form must be forwarded to the relevant RHE and copied to the Critical Incident Handling Officer.
B-4 Soil Contamination Date, Time and Period (Any Record) (dd/mm/yyyy) AM Annex 4 B-5 Noise and Vibration Date, Time and Period of Measurements (dd/mm/yyyy) AM to (dd/mm/yyyy) PM Annex 5 B-6 Odor Date, Time and Period (Any Record) (dd/mm/yyyy) AM Annex 6 B-7 Hazardous and Chemical Substances Date, Time and Period (Any Record) (dd/mm/yyyy) AM Annex 7 B-8 Greening Plan Date, Time and Period (Any Record) (dd/mm/yyyy) AM Annex 8 B-9 Landscape Date, Time and Period (Any Record) (dd/mm/yyyy) AM Annex 9 B-10 Local Water Use Date, Time and Period (Any Record) (dd/mm/yyyy) AM Annex 10 B-11Occupational Health and Safety Date, Time and Period (Any Record) (dd/mm/yyyy) AM Annex 11 B-12 Community Health and Safety Date, Time and Period (Any Record) (dd/mm/yyyy) AM Annex 12 B-13 Other Social Considerations Date, Time and Period (Any Record) (dd/mm/yyyy) AM Annex 13 B-14 Emergency Risks Date, Time and Period (Any Record) (dd/mm/yyyy) AM Annex 14 B-15 Transboundary or Global issues Date, Time and Period (Any Record) (dd/mm/yyyy) AM Annex 15 Note If there is not applicable item, please fill “Not Applicable”
Month/Year CSR Activities Village Tract/Ward/Village that received CSR Contribution Expenditures for CSR Activities Note 13.2 Employment of local people. □ Yes □ No If marked “Yes”, please provide information as follows: Period Total No. of Employees Number of employees from Thanlyin and Kyauktan Tsp. Number of employees from Relocation Site Recorded date Last Monitoring Periods During This Monitoring Period Next Monitoring Period Note: This should include all workers employed for operation within the SEZ by locator. B-14 Emergency Risks 14.1Records of emergency events such as fire, flood, earthquake Month/Year Type of Emergency Event Description Response Actions
: Organisational and Legal Dimensions Free text Is the registrar at the competency level expected for their level of training? Unable to assess Well below expected level of competence Below expected level of competence At expected level of competence Above expected level of competence Overall comments (including areas to be worked on) As an overall assessment, is the registrar at the competency level expected for their level of training? Unable to assess Well below expected level of competence Below expected level of competence At expected level of competence Above expected level of competence Has this feedback been discussed with the supervisor? YES NO N/A Has the Learning Plan/Log Book been reviewed and discussed with the registrar? YES NO N/A Exam When is the GPR intending to sit the exam?
100% form and force-locking gap compensation in hydraulic steel construction: Metal polymer supports dam management at Sylvensteinsee A former village sunken in Sylvensteinsee reappears: Alt-Fall in Upper Bavaria (Germany). Because for regular maintenance at the dam, the water reservoir near Lenggries had to be drained. Thus, after half a century, the foundations of the then flooded place came back to light. One of the maintenance challenges was to overhaul the guide rails of the dam's roll-up roller shutters, ensuring a 100% force-locking connection of the newly installed reinforcement on the guide rails. The Sylvensteinspeicher is much more than an ordinary lake. "Far" is the apt word: the Sylvensteinspeicher extends with a length of seven kilometers and a width of two kilometers along the road from Bad Tölz to the Achensee. As Bavaria's most important water reservoir, it forms the backbone of water regulation for the entire Isar Valley and thus also for the state capital and Oktoberfest metropolis Munich. In dry season, it ensures the adequate water supply of the Isar, which makes it ecologically indispensable for the entire area. The dam of the lake stands on one of the Isar over time filled with debris and up to 100 meters deep erosion channel. With it the Sylvensteinspeicher dams up the side of the Isar and their side inflows Dürrach and Walchen. Its two hydropower plants generate 25 million kilowatts of environmentally friendly electricity every year.
County: Telephone Number: ( ) - Residence Business Cell Date of Birth: Gender: Male Female Do you have a Social Security Number: Yes No If the person has been issued a social security number, (SSN), it must be provided to ensure the background check result is valid: Please list the SSN below: If this person does not have a Social Security Number, you must enter one of the following valid alternate number types: Alternative ID Type: Driver License: Number: State: State ID: Number: State Permanent Residency Card Number: Passport Number: Country Canadian SIN Number: Military ID Number: Has this person lived outside of Texas in the last 5 Years: Yes No Birth City: Birth State: Enter the previous physical address(es) for the background check subject in the space provided: Ethnicity (must accompany race): Hispanic Non-Hispanic Race: White Black Asian American Indian/Alaskan Native Native Hawaiian/ Pacific Islander
If you’ve used a respirator, have you ever had any of the following problems? (If you’ve never used a respirator, check the following space and go to question 9) Eye irritation: Eye irritation: Yes/No Skin allergies or rashes: Yes/No Anxiety: Yes/No General weakness or fatigue: Yes/No Any other problem that interferes with your use of a respirator: Yes/No Would you like to talk to the health care professional who will review this questionnaire about your answers to this questionnaire: Yes/No Questions 10 to 15 below must be answered by every employee who has been selected to use either a full-face piece respirator or a self-contained breathing apparatus (SCBA). For employees who have been selected to use other types of respirators, answering these questions is voluntary. Have you ever lost vision in either eye (temporarily or permanently): Yes/No Do you currently have any of the following vision problems? Wear contact lenses: Yes/No Wear glasses Yes/No Color blind: Yes/No Any other eye or vision problem: Yes/No Have you ever had an injury to your ears, including a broken ear drum: Yes/No Do you currently have any of the following hearing problems? Difficulty hearing: Yes/No Wear a hearing aid: Yes/No Any other hearing or ear problem: Yes/No Have you ever had a back injury: Yes/No Do you currently have any of the following musculoskeletal problems? Weakness in any of your arms, hands, legs, or feet: Yes/No Back pain: Yes/No Difficulty fully moving your arms and legs: Yes/No Pain or stiffness when you lean forward or backward at the waist: Yes/No Difficulty fully moving your head up or down: Yes/No Difficulty fully moving your head side to side: Yes/No Difficulty bending at your knees: Yes/No Difficulty squatting to the ground: Yes/No Climbing a flight of stairs or a ladder carrying more than 25 lbs: Yes/No Any other muscle or skeletal problem that interferes with using a respirator: Yes/No Updated March 2015
b) Are any other steps of manufacture of the products relevant to this audit (such as packaging, sterilising etc, but excluding provision of raw materials) contracted out to other manufacturers? Yes complete details below No go to Question 25 Name of Manufacturer Address Product Step(s) of Manufacture c) If the manufacturer to be audited does not perform release for supply of the product, who does perform this step? Name of Manufacturer Address Product DOCUMENTATION / PROCEDURES a) Please provide a list of the Standard Operating Procedures (SOPs) and methods used on the site. (attach list if preferred) b) Please attach copy of Master Validation Plan, if any. COMPUTERS a) Are computers used for: monitoring status of raw materials, intermediates, finished product? controlling manufacturing operations? controlling stock levels? calculating formulation quantities?
2.5.8 Primates – e.g. marmosets 2.5.9 Parrots, parakeets and macaws 2.5.10 Pigeons 2.5.11 Any other large birds – specify types below: 2.5.11.1 2.5.11.2 2.5.12 Budgerigars, finches and other small birds 2.5.13 Tortoises 2.5.14 Snakes and lizards 2.5.15 Tropical fish 2.5.16 Marine fish 2.5.17 Cold water fish 2.5.18 Any other species – specify types below: 2.5.18.1 2.5.18.2 2.6 Veterinary surgeon 2.6.1 Name of usual veterinary surgeon 2.6.2 Company name 2.6.3 Address 2.6.4 Phone number 2.6.5 Email address 2.7 Emergency key holder 2.7.1 Do you have an emergency key holder? Yes No – if 'No', go to 2.8.1 2.7.2 Name
Section 6 – keeping or training animals for exhibition The Animal Welfare (Licensing of Activities Involving Animals) Regulations 2018 6.1 Type of application 6.1.1 Have you been registered or licenced before? Yes No – if 'New', go to 6.1.4 6.1.2 Local authority where registered or licenced 6.1.3 Give details of registration – for example, type and numbers of animals, type of performance or exhibition Further information about the applicant 6.1.4 Stage name (if any) 6.1.5 Nationality 6.2 Type of business or performance – select all that apply 6.2.1 TV, film or social media Yes No 6.2.2 Theatre Yes No 6.2.3 Circus using domestic animals Yes No 6.2.4 Exhibiting animals Yes No 6.2.5 Animal encounters Yes No 6.2.6 Birds of prey shows or exhibits Yes No 6.2.7 Others – please state 6.3 Premises where animals will be trained 6.3.1 Name of premises/trading name 6.3.2 Address of premises 6.3.3 Phone number 6.3.4 Email address 6.4 Kinds of animal to be trained and the number of each kind 6.4.1 Kind of animal 6.4.2. Number 6.4.3 Add another kind of animal? Yes No – if 'Yes', please attach a separate sheet to repeat points 6.4.1 to 6.4.2 for each.
6.8.1 Do you have an emergency key holder? Yes No – if 'No', go to 6.9.1 6.8.2 Name 6.8.3 Position/job title 6.8.4 Address 6.8.5 Daytime phone number 6.8.6 Evening or other phone number 6.8.7 Email address 6.8.8 Add another person? Yes No – if 'Yes', please attach a separate sheet to repeat points 6.8.2 to 6.8.7 for each. 6.9 Public liability insurance 6.9.1 Do you have public liability insurance? Yes No – if 'No', go to 6.9.6 If 'Yes', please provide details of the policy 6.9.2 Insurance company 6.9.3 Policy number 6.9.4 Period of cover 6.9.5 Amount of cover (£m) Now go to 6.10. 6.9.6 What steps you are taking to obtain such insurance? 6.10 Disqualifications and convictions Has the applicant, or any person who will have control or management of the establishment, ever: 6.10.1 Been disqualified from keeping a pet shop? Yes No 6.10.2 Been disqualified from keeping a dog? Yes No 6.10.3 Been disqualified from keeping an animal boarding establishment? Yes No 6.10.4 Been disqualified from keeping a riding establishment? Yes No 6.10.5 Been disqualified from having custody of animals? Yes No
Burton Sweet Charities and Civil Society Department Form for directors’ details (electronic incorporation of new charitable company) Our ref: CG/KC Proposed company name: Client Name: Date: IMPORTANT – please complete and return by e mail, fax or post as soon as possible e mail or fax: 0117 9733781 post: Sweet, Pembroke House, , This identity evidence for proposed directors is required by Companies House for security purposes. Do ensure each person gives their phone number (required by the Charity Commission for charitable companies). By completing this form you confirm the proposed directors have provided their consent to act as directors of the company (you should retain evidence of that consent in case of query) We will assume each person is ALSO to be a member of the new company. If different people will be the members please supply their full names and addresses. FULL forename(s) and surname of Director: Any previous names and dates during which they were used: Date of birth: Address (incl postcode): Telephone number: Nationality: Usual country of residence: Occupation: CONFIRMED this person has provided their consent to act as a director of this company: YES Or NO NB it is not possible for matters to proceed without this confirmation (Companies Act requirement)
TR-1: Standard form for notification of major holdings NOTIFICATION OF MAJOR HOLDINGS (to be sent to the relevant issuer and to the FCA in Microsoft Word format if possible)i 1a. Identity of the issuer or the underlying issuer of existing shares to which voting rights are attachedii: BLUEBIRD MERCHANT VENTURES LTD 1b. Please indicate if the issuer is a non-UK issuer (please mark with an “X” if appropriate) Non-UK issuer 2. Reason for the notification (please mark the appropriate box or boxes with an “X”) An acquisition or disposal of voting rights YES An acquisition or disposal of financial instruments An event changing the breakdown of voting rights Other (please specify)iii: 3. Details of person subject to the notification obligationiv Name Harwood Capital LLP City and country of registered office (if applicable) London, United Kingdom 4. Full name of shareholder(s) (if different from 3.)v Name Harwood Capital LLP City and country of registered office (if applicable) As above 5. Date on which the threshold was crossed or reachedvi: 12/03/2018 6. Date on which issuer notified (DD/MM/YYYY): 14/03/2018 7. Total positions of person(s) subject to the notification obligation % of voting rights attached to shares (total of 8. A) % of voting rights through financial (total of 8.B 1 + 8.B 2) Total of both in % (8.A + 8.B) Total number of voting rights of issuervii Resulting situation on the date on which threshold was crossed or reached 8.79% 8.79% 184,963,840 Position of previous notification (if applicable) 9.87% 9.87%