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["DVD『空手道型』申込書(個人）"]
[]
[]
[{"$nulls":6},"　送信日： 令和　　　　年　　　月　　　日"]
[]
[{"$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： 　大金",{"$nulls":4},"*発送はご入金の確認後となります"]
[]
["　【 記載項目 】"]
[]
["お申込者"]
[null,null,"1巻",null,"枚","×","@5,500円（税込）","＝",null,"円","・・・①"]
[null,null,"2巻",null,"枚","×","@5,500円（税込）","＝",null,"円","・・・②"]
[null,null,"3巻",null,"枚","×","@5,500円（税込）","＝",null,"円","・・・③"]
[null,null,"1・2・3巻セット\n(3枚1組）",null,"組","×","@16,500円（税込）","＝",null,"円","・・・④"]
[null,null,"送料","1～4枚　　/ セット１組",{"$nulls":4},"420円",null,"・・・⑤"]
[null,null,null,"　　＊合計5枚以上のお申込みの場合はご相談下さい\n　　　　　（受付 ： kohobu-2@jka.or.jp）"]
[null,null,"合計金額　（①＋②＋③＋④＋⑤）",{"$nulls":4},"＝",null,"円"]
["送付先（〒・ご住所）",null,"〒"]
[]
["電話番号",{"$nulls":7},"―"]
["お支払方法",null,"　　　　　　　銀行　　",null,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,null,"[郵便局　小石川郵便局　No.００１３０-１-７７８１７９]"]
["入　金　日",{"$nulls":5},"月",null,"日　(入金済）"]
["備　　考"]
[]
[null,"FAX-No","０３-５８００-３１００"]