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["【ＦＡＸ送信先 024-593-5502】   ※送信票は不要です。　ふくしま教育旅行再生事務局　八巻 行　"]
["平成２７年度教育旅行入込調査票"]
[]
["実施主体：福島県から業務を受託したふくしま教育旅行再生事務局の株式会社山川印刷所が行います。"]
["調査対象期間：平成２７年４月１日～平成２８年３月３１日",{"$nulls":14},"※「市町村名」、「施設名」は、必ず御記入をお願いいたします。"]
["回答期限：平成２８年５月１９日（木）までに御回答くださいますようお願いいたします。",{"$nulls":15},"(市町村名：   　　　　         )"]
["特記事項：ふくしまっ子事業に係る宿泊は一切除いてください。"]
["そ の 他：該当無しの場合でもお手数ですが御回答ください。",{"$nulls":14},"(施設名：   　 　　　　　　　　　　　　　　　　　　          )"]
[]
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["本調査票１枚に、全ての出発地（都道府県名、国名）を書ききれない場合は、お手数ですがこの用紙をコピーしてお使いください。"]