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["使用期日",null,null,null,null,null,null,null,null,null,null,null,null,null,"施設使用に係る注意事項"]
["使用時間",null,null,null,null,null,null,null,null,null,null,null,null,null,"〇施設使用は申請した時間内でご利用ください。\n〇施設使用後は、現状復旧して退出してください。\n〇施設物品等を破損してしまった場合には、事務室へご報告ください。\n〇申請書は施設使用予定日の前日までにご提出ください。\n〇施設使用をキャンセルする場合は、下記連絡先までご連絡ください。"]
["使用目的",null,null,null,null,null,null,null,null,"使用人数",null,null,null,"人"]
["室名等",null,"使用する箇所に\n〇印をつけてください",null,"使用料",null,null,"室名等",null,"使用する箇所に\n〇印をつけてください",null,"使用料"]
["第1研修室(洋)",null,null,null,null,null,"円","付属備品等",null,null,null,null,null,"円"]
["第2研修室(洋)",null,null,null,null,null,"円",null,null,null,null,null,null,"円"]
["第1会議室(和)",null,null,null,null,null,"円",null,null,null,null,null,null,"円"]
["第2会議室(和)",null,null,null,null,null,"円","ふれあい広場\n(ステージ)",null,null,null,null,null,"円"]
["楽屋",null,null,null,null,null,"円","展示広場",null,null,null,null,null,"円"]
["ステージ",null,null,null,null,null,"円","加  算  料",null,null,null,null,null,"円"]
["ホール",null,null,null,null,null,"円","冷暖房料",null,null,null,null,null,"円"]
["ホール・ステージ",null,null,null,null,null,"円","合　計",null,null,null,null,null,"円"]
["※使用料",null,null,null,null,null,null,null,"円","□ 全額免除\n□ 一部免除\n□ 70％減額"]
["備\n考"]
[null,"上記のとおり使用したいので許可くださるよう申請します。",null,null,null,null,null,null,null,null,null,null,null,null,"(お問い合わせ先)\n大江町町立ふれあい会館　事務室\n住所：山形県西村山郡大江町大字左沢306\nTEL：0237-62-3822\nMail：shakai@town.oe.yamagata.jp"]
[]
[]
["団体の名称"]
[]
["申請者住所"]
[]
["氏名",null,null,null,null,null,null,null,"TEL"]
[null,null,null,null,null,null,null,null,null,null,null,"受付"]
["大江町町民ふれあい会館長　殿"]