PREFERRED LANGUAGE:
Spoken:______________________
Written:______________________		
PREFERRED LANGUAGE:
Spoken:______________________
Written:______________________		
PREFERRED LANGUAGE:
Spoken:______________________
Written:______________________	

PREFERRED LANGUAGE:
Spoken:______________________
Written:______________________		
PREFERRED LANGUAGE:
Spoken:______________________
Written:______________________		
PREFERRED LANGUAGE:
Spoken:______________________
Written:______________________	

PREFERRED LANGUAGE:
Spoken:______________________
Written:______________________		
PREFERRED LANGUAGE:
Spoken:______________________
Written:______________________		
PREFERRED LANGUAGE:
Spoken:______________________
Written:______________________	

PREFERRED LANGUAGE:
Spoken:______________________
Written:______________________		
PREFERRED LANGUAGE:
Spoken:______________________
Written:______________________		
PREFERRED LANGUAGE:
Spoken:______________________
Written:______________________	

PREFERRED LANGUAGE:
Spoken:______________________
Written:______________________		
PREFERRED LANGUAGE:
Spoken:______________________
Written:______________________		
PREFERRED LANGUAGE:
Spoken:______________________
Written:______________________	

PREFERRED LANGUAGE:
Spoken:______________________
Written:______________________		
PREFERRED LANGUAGE:
Spoken:______________________
Written:______________________		
PREFERRED LANGUAGE:
Spoken:______________________
Written:______________________	

PREFERRED LANGUAGE:
Spoken:______________________
Written:______________________		
PREFERRED LANGUAGE:
Spoken:______________________
Written:______________________		
PREFERRED LANGUAGE:
Spoken:______________________
Written:______________________	

PREFERRED LANGUAGE:
Spoken:______________________
Written:______________________		
PREFERRED LANGUAGE:
Spoken:______________________
Written:______________________		
PREFERRED LANGUAGE:
Spoken:______________________
Written:______________________	

PREFERRED LANGUAGE:
Spoken:______________________
Written:______________________		
PREFERRED LANGUAGE:
Spoken:______________________
Written:______________________		
PREFERRED LANGUAGE:
Spoken:______________________
Written:______________________	

PREFERRED LANGUAGE:
Spoken:______________________
Written:______________________		
PREFERRED LANGUAGE:
Spoken:______________________
Written:______________________		
PREFERRED LANGUAGE:
Spoken:______________________
Written:______________________