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["アジア・オセアニア合宿参加申込書　（空手協会会員）"]
[]
[1,"参加講習会","第１回","第２回"," *参加する講習に○印をつけてください。"]
[null,"19歳以上 \\3,000/回\n18歳以下 \\1,500/回"]
[]
[2,"会員番号","一般　・　永年",null,"　　　　　　-　　　　　-"]
[3,"支部名","　　　　　支部"]
[4,"都道府県名"]
[5,"申込者"]
[6,"生年月日（西暦）",null,null,"年",null,"月",null,"日"]
[7,"現段位",null,"段"]
[]
[8,"現有資格","指導",null,"審査",null,"審判"]
[null,"取得年月日"]
[null,"有効期限"]
[]
[9,"受験資格","指導",null,"審査",null,"審判",null,"*18歳以下は受験不可"]
[]
[10,"受験段","　　　　　段",null,"*18歳以下で受験可能なのは3段まで"]
[null,null,"※受けない方は記入しないで下さい。"]
[11,"郵便番号　　　〒"]
[12,"住　所"]
[13,"電　話"]
[14,"入金日",null,"年",null,"月",null,"日"]
[]
[15,"振込先","みずほ銀行",null,null,"クレジットカード"]
[null,"みずほ銀行　飯田橋支店(061)　普通口座　２３７１９５４　日本空手協会会長　草原克豪"]
[null,"クレジットカードの方は当日受け付けます。"]
[16,"E-mail  ：　"]
[null,"※お持ちでない方は空欄でも結構です。"]
[null,"＜受験者記入欄＞"]
[17,"現段位取得年月日",null,null,"年",null,"月",null,"日"]
[18,"段位登録番号"]
[19,"修行年月",null,"年",null,"ヶ月"]
[]
["注１：段、資格を受験しない人は上記項目のうち、1･2･3･4･5･6･7・8・12・13・14・15・16のみの記入で可です。"]

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["アジア・オセアニア合宿参加申込書 　(他流派の方）"]
[]
[1,"参加講習会","第１回","第２回","　　　※参加する講習に○印をつけてください。"]
[null,"19歳以上 \\5,000/回\n18歳以下 \\3,000/回"]
[]
[2,"申込者 氏名"]
[3,"生年月日（西暦）",null,"年",null,"月",null,"日"]
[4,"住　所"]
[5,"電　話"]
[6,"E-mail  ：　"]
[null,"※お持ちでない方は空欄でも結構です。"]
[7,"修行年月",null,"年",null,"ヶ月"]
[8,"所属団体"]
[9,"現段位",null,"段"]
[10,"入金日",null,"年",null,"月",null,"日"]
[]
[11,"入金方法","銀行振込\n（みずほ銀行）",null,null,"クレジットカード"]
[null,"振込先　：みずほ銀行　飯田橋支店(061)　普通口座　２３７１９５４　日本空手協会会長　草原克豪"]
[null,"※クレジットカードの方は当日に支払いを受け付けます。"]