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[null,null," 　　福岡日伊協会入会申込書",null,null,null,null,null,null,null,null,null,null,null,null,"年会費(会計年度：4月1日-翌年3月31日）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"法人会員　￥30,000　/　1口"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"個人会員　￥3,000 　"]
[null,"                  ",null,null,null,null,null,null,null,null,null,null,null,null,null,"特別会員（学生）　￥1,000"]
[]
[null,null,null,"個人会員",null,null,null,null,null,"特別会員（学生）",null,null,null,null,null,"申込日",null,null,null,null,null,null,"年　　　　月　　　　日"]
[null,"フリガナ"]
[null,"ご芳名"]
[null,"住所",null,null,"〒"]
[]
[null,"電話番号",null,null,null,null,null,null,null,null,null,"携帯電話"]
[null,"メールアドレス"]
[null,"フリガナ"]
[null,"勤務先\n学校名"]
[null,"備　     考"]
[null,null,null,"法人会員"]
[null,"フリガナ"]
[null,"法人名"]
[null,"役   職  名"]
[null,"フ リ ガ ナ"]
[null,"ご　芳　名"]
[null,"所在地",null,null,"〒"]
[]
[null,"申込口数",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"口"]
[null,"担当者名"]
[null,"電話番号",null,null,null,null,null,null,null,null,null,"メールアドレス"]
[null,null,"備　　　考"]
[null,"★入会申込書にご記入頂いた情報は、会報誌の送付、セミナー、イベントのご案内等に使用させて頂きます。"]
[null,"　ご本人の承諾のない限り、前述の目的以外の使用、第三者に提供することはありません。"]
[]
[null,"福岡日伊協会事務局",null,null,null,null,"associazilne italo-giapponese di fukuoka",null,null,null,null,null,null,null,null,"事　務　局　欄"]
[null,"〒812-0011",null,null,"福岡市博多区博多駅前1-3-6",null,null,null,null,null,null,null,null,null,null,"会　　長",null,"常務理事",null,"事務局長",null,"担当者"]
[null,"Phone:092-476-2153　　　Fax:092-476-2634"]
[null,"Email:aigfukuoka2@galaxy.ocn.jp"]