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[]
[]
["令和4年度愛媛県身体障がい者福祉センター"]
["卓球バレー講習会"]
[]
["参加申込書"]
[]
[null,null,null,"　　　　　　　　年　　　月　　　日"]
[]
["愛媛県身体障がい者福祉センター所長　殿"]
["ふりがな\n\n氏　名",null,null,null,"性　別","男 ・ 女"]
[]
["生年月日","　大　昭　平","　　　年　　　　　月　　　　　日",null,"年　齢","歳"]
["住　所","　〒"]
[]
[]
[null,null,null,"電話番号"]
[null,null,null,"携帯電話"]
["障がい","有　 ・　 無"]
[null,"有の方は障がい名、等級など"]
["本人以外\nの連絡先"]
[]
["備　考"]
["※記入いただきました個人情報につきましては当センターの運営、安全管理にのみ利用いたします。"]