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["アライアンス・フォーラム財団－BRAC大学 マイクロファイナンス「顔の見える金融」\n【入門】コース 2014　ご案内 　申込書"]
["株式会社　風の旅行社 　行",{"$nulls":7},"(申込み用紙、履歴書、応募動機、すべて tojokoku@allianceforum.org へ提出下さい)"]
[null,"別紙取引条件説明書に記載の旅行条件及び旅行手配のために必要な範囲内での運送・宿泊機関等その他への提供、およびプログラムの企画・運営に必要な範囲でのアライアンス・フォーラム財団への個人情報の提供について同意の上、申し込みます。\n"]
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[{"$nulls":27},"申込日　　年　　　月　　　日"]
["出発日:",null,"2014年10月31日（金）",{"$nulls":6},"帰国日",null,"2014年11月8日（土）",{"$nulls":6},"期間",null,"7泊9日"]
["出発地：東京、成田空港",{"$nulls":13},"着地：バングラデシュ、ダッカ空港"]
["フリガナ",{"$nulls":11},"性別",null,"ローマ字名（パスポートと同じ表記で記入）"]
["申込者の",{"$nulls":11},"□","男","姓",{"$nulls":5},"/","名"]
[null,null,"お名前",{"$nulls":9},"□","女"]
["生年月日：　　19 　　年 　　月　 　日",{"$nulls":17},"国","□","日本"]
[{"$nulls":6},"（　　　　歳）",{"$nulls":11},"籍","□","その他（　　　　　）"]
["フリガナ",{"$nulls":17},"TEL",null,"(    )        -"]
["現住所",null,null,"〒",null,null,null,"-",{"$nulls":10},"FAX",null,"(    )        -"]
[{"$nulls":18},"携帯",null,"(    )        -"]
[{"$nulls":18},"E-mail："]
["勤務先名又は学校名",{"$nulls":12},"ご職業　（該当を○で囲んで下さい）"]
[{"$nulls":13},"会社員・会社役員・医師・看護婦・自営業・自由業"]
[{"$nulls":13},"・公務員・教職員・農漁業・学生・主婦・無職"]
[{"$nulls":13},"その他（　　　　　　　　　　　）"]
["フリガナ",{"$nulls":17},"TEL",null,"(    )        -"]
["勤務先所在地　〒",{"$nulls":8},"-",{"$nulls":10},"(内線　　　　　　　)"]
[{"$nulls":18},"E-mail："]
["ご旅行中の国内連絡先",null,null,null,"フリガナ",{"$nulls":13},"続柄"]
[{"$nulls":4},"お名前",{"$nulls":13},"TEL",null,"(    )        -"]
[{"$nulls":18},"FAX",null,"(    )        -"]
[{"$nulls":4},"住所",null,null,"（現住所と同じ場合は”同上”とご記入下さい）"]
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["現在有効なパスポートを",{"$nulls":9},"パスポート番号",{"$nulls":7},"パスポート発行日",{"$nulls":4},"パスポート有効期限"]
[null,"□","持っている"]
[null,"□","持っていない"]
["海外旅行障害保険加入について",{"$nulls":9},"海外渡航歴"]
[null,"□","「風の旅行社」で加入する",{"$nulls":7},"今回で",{"$nulls":4},"主な渡航先:欧州・米州・中南米・オーストラリア"]
[null,"□","他社で加入する",{"$nulls":11},"回目","中東・アフリカ・アジア・その他(           )"]
[null,"※個人情報保護法の関連で、情報は、必要最低限にして下さい。",{"$nulls":25},"<別紙「履歴書」に続く>"]

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[null,"履　　　歴　　　書"]
[null,"氏名：","___________________________"]
[{"$nulls":12},"年","月",null,"日現在"]
[null,"年","月","学歴（大学以上)"]
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[null,"年","月","職歴"]
{"$rows_empty":7}
[null,"年","月","ボランティア・海外経験"]
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[null,"年","月","免許・資格"]
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[null,"英語レベル"]
[null,"以下より選択（ひとつ）",{"$nulls":5},"英語資格(TOEFL/英検等)及び仕事での利用経験"]
[null,"□　ネイティヴレベル（TOEIC900～）"]
[null,"□　ビジネス一般（TOEIC700～）"]
[null,"□　ビジネス初級（TOEIC600～）"]
[null,"□　日常会話レベル     "]
[{"$nulls":15},"<別紙「応募動機」に続く>"]

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[]
[null,"応　　募　　動　　機"]
[null,"氏名：","___________________________"]
[{"$nulls":12},"年","月",null,"日現在"]
[null,"1. What interests (cultural, political, economic, social or otherwise) would you bring to this program?（Please answer in English）"]
[]
[]
[]
[]
[]
[]
[null,"2. What are your long-term goals (career goals or personal growth goals)?  How would participation in this program help you reach those goals?　 （Please answer in English）"]
[]
[]
[]
[]
[]
[]
[null,"\n3. 自己紹介・自己PR （日本語でご記入ください）"]