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["水質計測機器維持管理講習会参加申込書"]
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[null,null,null,"　　　　　　　　　　　平成 ２３年　　月　 　日"]
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["公益社団法人 日本環境技術協会　　御中 "]
["（FAX　０３－３２６３－３７４１）"]
[]
[null,"次のとおり受講を申し込みます。"]
[]
[null,"貴社（団体）名"]
[]
[null,"                                 〒"]
[null,"住　　　　　　所"]
[]
[]
[null,"所　　　　　　属"]
[]
[]
[null,"申　　込　　 者"]
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[]
[null,"電話：",null,null,"FAX："]
[]
[]
[]
[null,"◎関係団体の会員の状況等（次に該当する場合は○で囲んでください）"]
[]
[null,"（公社）日本環境技術協会",null,"正A","正B","賛A","賛B","賛C-1"]
[null,"（社）産業環境管理協会",null,"正A～C","地方公共団体"]
[]
[]
["（受講者名簿）"]
["会場名","ふ り が な",null,"所属部課・役職",null,"１日間","２日間","事務局欄"]
[null,"受講者氏名",null,"Eメール",null,"の受講","の受講","受講NO."]
[{"$nulls":5},"1日目"]
[{"$nulls":5},"２日目"]
[{"$nulls":5},"1日目"]
[{"$nulls":5},"２日目"]
[{"$nulls":5},"1日目"]
[{"$nulls":5},"２日目"]
[{"$nulls":5},"1日目"]
[{"$nulls":5},"２日目"]
[{"$nulls":5},"1日目"]
[{"$nulls":5},"２日目"]
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["■個人情報の保護について"]
["　１．本件でお預かりした個人情報については、当協会の「個人情報保護方針」に基づき、"]
["　    安全かつ適切に管理さていただきます。"]
["　２．ダイレクトメールによるこのような情報が、今後、不要な場合は下記□内にレ点をつ"]
["      けて、ご返送下さい。"]
[null,null,null,"　　　　　　　　　　　　　　今後このような情報は　不要□"]