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[{"$nulls":24},"公　　　益",null,"日本空手協会"]
[{"$nulls":24},"社団法人"]
[]
[{"$nulls":7},"段位審査用紙"]
[{"$nulls":7},"ＥＸＡＭＩＮＥＲ ´ Ｓ　ＲＥＣＯＲＤ "]
["（太枠内のみ記入のこと）"]
["(ふりがな)",{"$nulls":10},"性　　別",null,null,null,"  男",null,null,"女",null,null,null,"　審査日　　　 Date of  Examination"]
["氏　　　名　　\nName　",{"$nulls":10},"Sex",null,null,null,"Male",null,null,"Female",{"$nulls":8},"年",null,"月",null,"日"]
[{"$nulls":11},"年　齢",null,null,null,"満",{"$nulls":4},"才",null,"誕生日　　　　　　　Date of Birth"]
[{"$nulls":11},"Age",{"$nulls":15},"年",null,"月",null,"日"]
["支部・団体名",{"$nulls":10},"会　　員　　番　　号  Membership No.",{"$nulls":17}," "]
["Organization Name",{"$nulls":12},"-",null,null,null,"-"]
["本　　籍　\n　Nationality"]
["現　住　所　　　　　　　　　　　Present Address",{"$nulls":24},"Tel　(",{"$nulls":5},")"]
["道歴保証人　　　　　　　　　　Karate career\n   guarantor",null,null,"氏　　名　　　　　　　\nName",{"$nulls":12},"本人との関係　　Relationship"]
[]
[]
[null,"採　　　点　　　表"]
[]
[]
[null,"受　験　段　　　　　　　　　　　Rank　Being　　　　　　　　　　Tested for",{"$nulls":7},"段",null,null,null,"基　本",null,null,null,"形",null,null,null,"組　手",null,null,"応用技　　研　究　　　その他",null,"総　合",null,null,"決　定"]
[null,"現段 (級) 位　　　　　　　　　　Dan Kyu   Registration",{"$nulls":4},"級　　　Kyu",null,null,"段　　　　Dan",null,null,"A",{"$nulls":16},"審査長印"]
[null,"取得　　　　　　　　　　　　Date of Conferral",null,null,null,"年",null,"月",null,"日"]
[null,"段・級　　証書番号　　　　　　　　　\nDaｎ/Kyu Registration No.",{"$nulls":10},"Ｂ",{"$nulls":16},"合　 格"]
[null,"修　業　年　月　　　　　　　　　Number of  Months and Years in Karate Training",{"$nulls":5},"年",null,"ヶ月",{"$nulls":19},"不合格"]
[{"$nulls":5},"Years　　 Months"]
[null," 現取得資格　　Present Qualifcations　　",{"$nulls":10},"備考",{"$nulls":16},"再審査"]
[null," 指導　Instructor",{"$nulls":6},"級  Class"]
[null," 審査 Examiner",{"$nulls":6},"級 Class",null,null,null,"受験料",{"$nulls":11},"登録料"]
[null," 審判 Judge",{"$nulls":6},"級 Class"]
[]
[]
[{"$nulls":8},"✂",null,null,null,"✂",{"$nulls":5},"✂"]
[]
[null,null,null,"受　　験　　票",{"$nulls":15},"領収印","受　　験　　料",{"$nulls":5},"登　　録　　料"]
[null,"受　験　段  　　　　　　 Rank Being  　　  Tested for"]
[null,null,null,"AUTHORIZATION TO TAKE EXAMINATION"]
[null,null,null,"氏　　　名  Name",{"$nulls":8},"　　　会員番号　　　　　　Membeｒship number",{"$nulls":5},"№",{"$nulls":4},"　　　審　査　日　　　　Date of　　Examination",null,null,null,"年",null,"月",null,"日"]
[null,null,"段　Dan"]
[]
[null,"①　段位証書を受け取るときは必ずこの票を提出して下さい。",{"$nulls":13}," Sign this slip and hand it in wihtin three months；"]
[null,"②　不合格のときはこの票と引き換えに段位登録料を払い戻しします。",{"$nulls":13},"① to receive゛dan ゛certificate "]
[null,"いずれの場合も３ヶ月以内にこの票を事務所に提出して下さい。",{"$nulls":13},"②  in case of failure, to receive refund ofregistration fee."]
[{"$nulls":24},"公　　　益",null,"日本空手協会"]
[{"$nulls":24},"社団法人"]

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["受　　　験　　　要　　　領"]
[]
["(1)","受験希望者は、段位審査用紙及び受験票に必要事項記入の上、協会規定の審査料及び段位"]
[null,"登録料を添えて会員証持参の上審査日の前日迄に事務所に提出し引替に受験票を受取る"]
["(2)","会費（個人及び団体会員共）未納者は受験資格がないので必ず審査の月までの会費を納入の事"]
["(3)","審査当日は指定された時間の30分前に会場に入り、係員の指示に従う事"]
["(4)","受験料は返金しない"]
["(5)","不合格者には段位登録料を払い戻す"]
["(6)","段位証書の交付、または不合格による段位登録料の払い戻しを受けるときは、受験票の裏面に"]
[null,"記名押印の上、3ヶ月以内に提出の事"]
[]
[]
[]
["ＤＥＴＡＩＬＳ　ＲＥＧＡＲＤＩＮＧ　ＥＸＡＭＩＮＡＴＩＯＮ"]
[]
["(1)","Fill in all information asked for under EXAMINER'S RECORD，and AUTHORIZATION TO TAKE"]
[null,"EXAMINATION and submit with examination fee and registration fee not later than the day before"]
[null,"the scheduled examination．"]
[null,"Outside of Japan, both examination fee and registration fee shoud be submitted in accordance"]
[null,"with the stipulation of the club or the dojo you belong to, affiliated with JKA．"]
[null,"         １．Examination fee"]
[null,"         ２．Registration fee"]
["(2)","Those who have not paid their membership fee for the month during which the examination "]
[null,"is scheduled will not be allowed to take the examination．"]
["(3)","You should appear at the place of examination at least 30minutes before the time scheduled for "]
[null,"the examination and await the instructions from the person in charge．"]
["(4)","The examination fee will not be returned in any case．"]
["(5)","The registration fee will be returned to those who fail the examination．"]
["(6)","When receiving “dan” certificate or refund of registration fee，sign on the reverse side，and "]
[null,"hand over  the attached “Authorization to Take Examination” within three months of taking "]
[null,"the examination．"]