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[null,null,"令和６年度　福祉のしごと施設見学会　参加申込書"]
["　FAX043-306-1281　千葉県福祉人材センター行"]
[null,"申込日　　令和　　年　　月　　日　　　"]
[null,"見学希望\n施設","☐ワーナーホーム　本部拠点(大網白里) ",null,null,null,"☐ 特別養護老人ホーム長生共楽園 "]
[null,null,"※見学を希望する施設の方に☑してください（両方でも可）"]
[null,"フリガナ","　　"]
[null,"名前"]
[null,"年代","　　１０代　　　２０代　　　３０代　　　４０代　　　５０代　　　６０代以上"]
[null,"住所","〒"]
[null,"携帯番号"]
[null,"メールアドレス"]
[null,"状況","　研修生,学生　就業中　就活中(1年未満)　就活中(1年以上)　その他(　　             　)　"]
[null,"資格","福祉に関係する資格(例：看護師、介護福祉士、保育士等）"]
[null,"経験","　・初めて訪問　・面会、見学などで訪問　・勤務していた　・その他"]
[null,"　　　　　　　※応募多数の場合、抽選で決定いたします。なお、参加者１名でも実施します。"]