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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"財団記入欄"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年",null,null,null,null,"月",null,null,null,null,"日",null,"受領"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"応募番号："]
["公益財団法人",null,null,null,null,null,null,null,null,null,"川嶋みらい文化芸術財団"]
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["代表理事",null,null,null,null,null,null,null,null,null,null,null,null,"川嶋　尚道",null,null,null,null,null,null,null,null,null,null,"殿"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"完 了 報 告 書"]
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[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"令和",null,null,null,null,null,null,null,"年",null,null,null,null,null,"月",null,null,null,null,null,"日"]
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[null,null,null,null,null,null,null,null,null,"氏　名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"㊞"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※グループ・団体の場合は、代表者の役職・氏名を記載してください"]
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[null,null,null,null,null,null,null,null,null,"名　称"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※グループ・団体の場合のみ、その名称を記載してください"]
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["活 動 名 称"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※助成を受けた活動の名称を記載してください"]
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["助成対象者に関する事項",null,null,null,"氏　　　名",null,null,null,null,null,null,null,null,null,null,null,null,"ﾌﾘｶﾞﾅ"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※グループ・団体の場合は、代表者の役職・氏名を記載してください"]
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[null,null,null,null,"名　　　称",null,null,null,null,null,null,null,null,null,null,null,null,"ﾌﾘｶﾞﾅ"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※グループ・団体の場合のみ、その名称を記載してください"]
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[null,null,null,null,"窓　　　口\n担　当　者",null,null,null,null,null,null,null,null,null,null,null,null,"ﾌﾘｶﾞﾅ"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※グループ・団体の場合のみ、窓口担当者の氏名を記載してください"]
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[null,null,null,null,"連　絡　先",null,null,null,null,null,null,null,null,null,null,null,"〒",null,null,null,null,null,null,"-"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"TEL",null,null,null,null,null,null,null,null,null,null,"-",null,null,null,null,null,null,null,"-",null,null,null,null,null,null,null,"（携帯電話の番号可）"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"FAX",null,null,null,null,null,null,null,null,null,null,"-",null,null,null,null,null,null,null,"-",null,null,null,null,null,null,null,"（FAXがない場合、記載不要）"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"MAIL",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"@"]
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["Ⅰ．助成を受けた活動の成果"]
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["助成を受けた活動の成果"]
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["※スペースが足りない場合や資料がある場合は、別途添付してください"]
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["Ⅱ．助成金の支出金額 ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（適用欄には、使途・数量・単価等を記載してください）"]
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["費 用 項 目",null,null,null,null,null,null,null,null,null,null,null,null,null,"摘　　要",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"金　額 （円）"]
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["例）消耗品費",null,null,null,null,null,null,null,null,null,null,null,null,null,"　例）---に使用する---の購入\n　例）数量：　--- 個, 単価： --- 円",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"例）10,000"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"合計"]
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["※証憑書類（領収証・請求書等の写し）を別途添付してください"]