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["ＪＫＡ 空手道型教本　申込書 "]
[]
[{"$nulls":5},"　送信日： 令和　　　年　　　月　　　日"]
[]
[{"$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",null,null,"都道府県No",null,"支部No",null,"会員No"]
[{"$nulls":6},"―",null,"―"]
["個数（税込金額）",null,"第1巻","冊","×","@3500円","＝",null,"円","・・・①"]
[null,null,"第2巻","冊","×","@3500円","＝",null,"円","・・・②"]
[null,null,"第3巻","冊","×","@3500円","＝",null,"円","・・・③"]
[null,null,"第4巻","冊","×","@3500円","＝",null,"円","・・・④"]
[null,null,"第5巻","冊","×","@3500円","＝",null,"円","・・・⑤"]
[null,null,"送料",{"$nulls":6},"・・・⑥"]
[null,null,"【送料】\n１．）2冊まで・・・全国一律 420円\n\n２．）3冊～5冊\n【青森・秋田・岩手・宮城・福島・山形・東京・神奈川・埼玉・千葉・栃木・茨城・群馬･山梨・長野・新潟・富山・石川・福井・愛知・三重・岐阜・静岡】・・・600円\n【北海道全域・大阪・兵庫・奈良・和歌山・京都・滋賀・広島・岡山・山口・鳥取・島根・香川・徳島・高知・愛媛・福岡・佐賀・長崎・大分・熊本・宮崎・鹿児島・沖縄】・・・950円\n\n３．）6冊以上…　keiribu-9@jka.or.jp　にお問い合わせ下さい"]
[null,null,"合計金額　（①＋②＋③＋④＋⑤＋⑥）",null,null,null,"＝",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，公益社団法人　日本空手協会]"]
["[ 何れかに レ点 を表示 ]",null,"　　　　　郵便局",null,"[小石川郵便局　No.００１３０-１-７７８１７９，公益社団法人　日本空手協会]"]
[null,null,"          クレジットカード払い（メール決済：メールでURL決済リンクをお送りします）"]
[null,null,null,"　【メールアドレス】　"]
["入　金　日",null,null,null,"月",null,"日　","(入金済）"]
["備　　考"]
[]
[null,"FAX-No","０３-５８００-３１００"]