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[]
["ＪＫＡ リュックサック（型教本つき）　申込書"]
[]
[]
[{"$nulls":7},"　　送信日： 平成　　　年　　　月　　　　日"]
[]
[{"$nulls":7},"発信者："]
["公益社団法人 日本空手協会",{"$nulls":6},"氏名 ：　"]
["　　　ＴＥＬ：　（０３） ５８００-３０９１",{"$nulls":6},"電話番号："]
["　　　FAX ：　（０３） ５８００-３１００"]
["　 担当： 　山本"]
[]
[]
["　【 記載項目 】"]
[]
["お申込者"]
["支部名[支部番号]",null,"支部名",{"$nulls":5},"都道府県No","―","支部No"]
["個数（税込金額）",null," 個数","×","@3,500円","＋","500円（送料）","＝","合計金額",null,"円　"]
["送付先（〒・ご住所）",null,"〒"]
[]
["電話番号",null,"　（","）　",null,null,null,"―"]
["お支払方法",null,"　　　　　　銀行",null,"[みずほ銀行 飯田橋支店　No.２３７１９３８]"]
["[ 何れかに レ点 を表示 ]",null,"　　　　　　郵便局",null,"[郵便局　小石川郵便局　No.００１３０-１-７７８１７９]"]
["入　金　日",null,null,"月",null,null,null,"日　(入金済）"]
["備　　考",null,"＊型教本が不要な場合はお知らせください。"]
[]
[]
[null,"FAX-No","０３-５８００-３１００"]