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["〔様式２〕",{"$nulls":14},"ＮＯ．"]
["（B）引越管理者講習　〔申込書 兼 受講票〕 "]
[]
["秋田県",null,"トラック協会",null,"協会コード","005"]
["※所属協会名を記入して下さい。"]
[]
[{"$nulls":5},"受講コード\n(個人コード)"]
[]
[]
["① 氏　名","せい",null,"めい",{"$nulls":4}," ※ふりがなを必ず記入して下さい。"]
[{"$nulls":8}," ※通常のパソコンで表示できる範囲の漢字を使用して下さい。"]
[" ② 生年月日"]
["③ 性　別"]
[null,"会社名",{"$nulls":5},"営業所／支店名"]
["　　　④ 事業所名"]
["　　　⑤ 事業所住所","〒"]
[]
["⑥ 電話番号・ＦＡＸ"]
[null,null,"　※受講者本人と連絡のつく事業所の電話番号・ＦＡＸ番号を市外局番から記入して下さい。"]
[]
[{"$nulls":6},"受講日",null,null,null,"令和８年９月１０日（木）"]
[{"$nulls":6},"受講地",null,null,null,"(公社)秋田県トラック協会"]
[]
["※提出いただいた個人情報については、引越講習修了証発行に係る業務以外には\n　使用致しません。また、この書類は返却致しませんのでご了承下さい。"]
[{"$nulls":10},"公益社団法人全日本トラック協会"]
[]
[]
["【当日持参して頂くもの】"]
["　□　筆記用具"]
["　□　名刺"]
["※グループ討議の際、名刺交換致しますので複数枚ご持参下さい。"]
[]
["　□　※引越講習テキスト"]
["※前日に基本講習を受講される方は、基本講習で使用したテキストをご持参下さい。"]