Ȩ Ұ ̱б ⺸谡Խû ܱ⺸谡Խû û
 
 
 



home DBغ ۼ
Ʒ Է¶ Ȯ Էּ.
ػ е ñ װ 帱 ó Թٶϴ.
Է ư ŬϿ ֽñ ٶϴ. (* ǥõ κ ʼ Է»Դϴ.)
 
  ǹȣ   ٸ ຸ (/)  

 

* Name
ѱ
*ID Number ֹιȣ
-
Nationality

* Address ѱּ (ּ ȭȣ ѱ Ǵ ؿ ϳ ʼ Էϼž մϴ)
ȣ ã -

Contact ȭȣ
Home -            Mobile -

* Address ؿּ
Street address      
       
       
City      
State   ZIP / Postal cod

Contact ȭȣ
Home - -            Mobile - -

* Email Address ̸ ּ   Occupation
@  


Emergency Contact ѱ ó
Name ̸    Relationship Ǻڿ    Contact ȭȣ - -


Payment To ѱ
Bank Name    Payee
Account No ¹ȣ


 

  * Accidental Case ػ   Sickness Case
  *
Date   Time ð   Place
  * Description of Circumstances(5W1H) Ȳ (6ϿĢ) ܸ ٶϴ
   


 

Physicians / Hospital
Medicine ప
Other Ÿ
Total Ѱ


 

  * Ƿ : ּ, ó, ,
   




û ʺ

Ǵ ε Ƿ, ܼ / Ͽ ش Ƿ ߻Ǿų ߻ ġ Ƹ޸ī Ȩ  įĴ ѱ(Chartis Korea) ش Ƿ Ͽ ûմϴ. û öȸϱ ȿϸ, öȸ û ϴ ߻ ġ Ͽ ش Ƿ û Ǵ Ͱ, ޼ 츮 ȸ û ϴ Ϳ մϴ. ƿ﷯, ް ػ ν ִ Ƿ ǹǷ, Ƹ޸ī Ȩ  įĴ ѱ(Chartis Korea) 谡Աݾ ѵ Ƿ Ͽٸ, ٸ ȸ å κп Ͽ ûϿ ϴ Ϳ ϸ, ̿ Ƹ޸ī Ȩ  įĴ ѱ(Chartis Korea) մϴ.


νſ Ȱ Ǽ

ſ ſ ̿ ȣ 32 Ÿο Ǵ ̿ Ǹ ϴ μ, ػ Ͽ ſ Ƹ޸ī Ȩ  įĴ ѱ(Chartis Korea) 븮ο , Ȱǰų Ƹ޸ī Ȩ  įĴ ѱ(Chartis Korea) Ÿ 翡 Ǵ Ϳ մϴ.

1) : ǰ, Ƿ, ,
2) Ȱ볻 : , ġɻ, ޿޳, Ұ߱
3) : , 뿩, , Կ