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["様式１"]
[{"$nulls":4},"公益社団法人　岐阜県建築士会入会申込書（正会員・準会員用）"]
[]
[]
["　私は、公益社団法人岐阜県建築士会の正会員（準会員）として入会をしたいので、入会金及び"]
["会費を添えて、入会を申し込みします。"]
["　私は、入会の上は、貴法人の定款、倫理規程及び諸規程を遵守し、社員総会及び理事会の決"]
["定に従います。"]
[]
[{"$nulls":7},"平成　年　月　日"]
[]
["公益社団法人　岐阜県建築士会会長　　　様"]
[{"$nulls":7},"（自筆署名）"]
[{"$nulls":6},"氏　　名"]
[]
["ふりがな",null,null,null,"男","生　年","昭和"]
["氏　　名",null,null,null,"・"]
[{"$nulls":4},"女","月　日","平成","　　　年　　月　　日生"]
["本籍地",null,null,"都道府県","最終学歴"]
["ふりがな"]
[null,"〒　　　　　－"]
["現住所"]
[null,"TEL（　　　　　）　　　　　　－",null,null,null,"E-mail"]
["ふりがな"]
["勤務先","（名　　　称　・　所　　属　　部　　署）"]
[]
[]
["ふりがな"]
["勤務先"]
["の"]
["住所地","TEL（　　　　　）　　　　　　－",null,null,null,"FAX（　　　　　）　　　　　　－"]
[null,"種　別","登　録　年　月　日",null,null,"登　録　番　号"]
[null,"一級","昭和"]
[null,null,"平成"]
["建築士免許","二級","昭和"]
[null,null,"平成"]
[null,"木造","昭和"]
[null,null,"平成"]
["会員種別","・正会員",null,null,null,"紹　介","所属支部名"]
[null,"・準会員",null,null,null,"正会員","氏　　名"]
["所属支部名"]
["本部入会金",null,"円"]
["本部会費",null,"円　（平成　　年　　月分　～　平成　　年　　月分まで）"]
["個人情報公","・氏名　・現住所　・電話番号　・勤務先　・勤務先の住所地　・勤務先電話番号　"]
["開の同意事項","・会員種別　・建築士資格種別"]
[]
[]
[]
[]
[]
[null,"※",null,"支　部　名",null,null,null,"本部会費納入日"]
[null,"事務局使用欄"]

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