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["【ＦＡＸ送信先 024-593-5502】   ※送信票は不要です。　株式会社 山川印刷所　片岡 行　"]
["令和３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株式会社 山川印刷所が行います。",{"$nulls":14},"※「市町村名」、「施設名」は、必ず御記入をお願いいたします。"]
["調査対象期間：２０２１年４月１日～２０２２年３月３１日",{"$nulls":14},"(市町村名：   　　　　     　　　　　　　    )"]
["回答期限：２０２２年５月３０日（月）までに御回答くださいますようお願いいたします。",{"$nulls":14},"(施設名：   　 　　　　　　　　　　　　　　　　　　　　　　　　　          )"]
["特記事項：ふくしまっ子事業に係る宿泊は一切除いてください。",{"$nulls":14},"□","2021年４月1日～2022年3月31日の間、調査対象教育旅行に該当する宿泊の受入はありません。"]
["そ の 他：該当無しの場合、お手数ですが右の□へチェックを入れて御回答をお願いいたします。"]
[]
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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。"]