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[null,null,"■申込み先■",null,null,"福島県建築指導課（民間建築担当：中島）宛"]
[null,null,"＜FAXの場合＞",null,null,"０２４－５２１－８０４９　（送信票不要）"]
[null,null,"＜メールの場合＞",null,null,"kenchikushidou@pref.fukushima.lg.jp"]
[null,null,"＜郵送の場合＞",null,null,"〒960-8670　福島市杉妻町2番16号（本庁舎4階）"]
[]
[null,null,"「福島県木造住宅耐震診断技術講習会」受講申込書"]
[]
[null,null,"令和２年１月２７日（月）　ビッグパレットふくしま　１３：３０～１７：００"]
[]
[null,null,1,"フリガナ",null,null,"所属\n会社名"]
[null,null,null,"受講者\n氏 　名",null,null,"会社\n住所","〒"]
[]
[null,null,null,"受講者の緊急連絡先（携帯電話等）"]
[null,null,null,"　( 　　　　   　    )       　　　　　  -       ",null,null,"会社\n電話","　（　　　　　　　　　）　　　　　　　　　－　　　　　"]
[null,null,2,"フリガナ",null,null,"所属\n会社名"]
[null,null,null,"受講者\n氏 　名",null,null,"会社\n住所","〒"]
[]
[null,null,null,"受講者の緊急連絡先（携帯電話等）"]
[null,null,null,"　( 　　　　   　    )       　　　　　  -       ",null,null,"会社\n電話","　（　　　　　　　　　）　　　　　　　　　－　　　　　"]
[null,null,3,"フリガナ",null,null,"所属\n会社名"]
[null,null,null,"受講者\n氏 　名",null,null,"会社\n住所","〒"]
[]
[null,null,null,"受講者の緊急連絡先（携帯電話等）"]
[null,null,null,"　( 　　　　   　    )       　　　　　  -       ",null,null,"会社\n電話","　（　　　　　　　　　）　　　　　　　　　－　　　　　"]
[null,null,4,"フリガナ",null,null,"所属\n会社名"]
[null,null,null,"受講者\n氏 　名",null,null,"会社\n住所","〒"]
[]
[null,null,null,"受講者の緊急連絡先（携帯電話等）"]
[null,null,null,"　( 　　　　   　    )       　　　　　  -       ",null,null,"会社\n電話","　（　　　　　　　　　）　　　　　　　　　－　　　　　"]
[null,null,5,"フリガナ",null,null,"所属\n会社名"]
[null,null,null,"受講者\n氏 　名",null,null,"会社\n住所","〒"]
[]
[null,null,null,"受講者の緊急連絡先（携帯電話等）"]
[null,null,null,"　( 　　　　   　    )       　　　　　  -       ",null,null,"会社\n電話","　（　　　　　　　　　）　　　　　　　　　－　　　　　"]
[]
[null,null,"※令和２年１月１７日（金）までにFAX、郵送又はメールにてお申し込みください。"]
[null,null,"※この申込みに記載された個人情報は、本講習会実施に関する必要な書類等の作成に使用します。（それ以外の目的には使用いたしません。）"]
[]
[null,null,"※受講者欄が不足する場合は、本様式をコピーして使用してください。"]