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["令和　　　年　　　月　　　日"]
["柏市民ギャラリー備品等使用申込書"]
[]
["　柏市民ギャラリー　指定管理者　　あて"]
[]
[{"$nulls":5},"申込者",null,null,"団体名"]
[]
[{"$nulls":8},"氏　　名",null,null,"役職名",{"$nulls":5},"氏名"]
[]
[{"$nulls":8},"住　　所",null,null,"〒",{"$nulls":5},"電話番号"]
[]
[]
[null,"　柏市民ギャラリーの使用にあたり，備品等を使用したいので，次のとおり申込みます｡　　　　　"]
[]
[]
[null,"行　事　名"]
[]
[null,"使　用　日",null,null,null,"令和　　　年　　　　月　　　　日　（　　　　）　　から",{"$nulls":13},"日　数",null,null,"　　　　　　　　　日"]
[{"$nulls":5},"令和　　　年　　　　月　　　　日　（　　　　）　　まで",{"$nulls":16},"　(　　　　　　日を除く)"]
[null,"使用備品",null,null,null,"　□展示台　天板　　　　　　　",{"$nulls":10},"　□展示ケース（片面覗き・照明付き）"]
[{"$nulls":16},"　",{"$nulls":9},"台"]
[{"$nulls":6},"W1800×D600",{"$nulls":8},"枚","　□フック（天井付き型・引っ掛け型）"]
[{"$nulls":16},"　",{"$nulls":9},"個"]
[{"$nulls":6},"W900×D600",{"$nulls":8},"枚","　□ワイヤー"]
[{"$nulls":16},"　",{"$nulls":9},"本"]
[{"$nulls":6},"W450×D450",{"$nulls":8},"枚","　□折り畳みテーブル"]
[{"$nulls":5},"　□展示台　脚（天板一枚に対し2本必要です）",{"$nulls":10},"　",{"$nulls":9},"台"]
[{"$nulls":16},"　□ＢＧＭシステム"]
[{"$nulls":6},"W420×D420×H900",{"$nulls":8},"本",null,null,"CDMDラジカセ",{"$nulls":7},"台"]
[{"$nulls":16},"　□電源(コンセント）を必要とする作品数"]
[{"$nulls":6},"W420×D420×H600",{"$nulls":8},"本","（ダウンライト，スポットライトを除く）"]
[{"$nulls":5},"　□スポットライト",{"$nulls":20},"点"]
[{"$nulls":15},"個","　 総ワット数",{"$nulls":9},"W"]
[null,"エアタイト\nケース　　",{"$nulls":4},"利用　　有　　・　　無"]
[{"$nulls":5},"　□展示台（エアタイトケース用）　"]
[{"$nulls":6},"W900×D450×H900",{"$nulls":8},"個",null,"W450×D450×H900",{"$nulls":8},"個"]
[{"$nulls":6},"W900×D450×H600",{"$nulls":8},"個",null,"W450×D450×H600",{"$nulls":8},"個"]
[null,"箱型パネル",null,null,null,"　□W1220×D520×H2200",{"$nulls":10},"　□W1120×D520×H2200"]
[{"$nulls":15},"個",{"$nulls":10},"個"]
[null,"その他"]
[]
[null,"■　記載方法　(柏市民ギャラリー備品等使用申込書)"]
[]
[null,1,"日付欄"]
[null,null,"　申込みの日を記載してください。"]
[]
[null,2,"申込者欄"]
[null,null,"　申込者の属する団体名，申込者の役職名と氏名，申込者の住所，郵便番号，電話番号を記載してください。"]
[]
[]
[null,3,"行事名欄"]
[null,null,"　行事名を正確に記載してください。"]
[]
[]
[null,4,"使用日欄"]
[null,null,"　使用予定日を記載してください。"]
[]
[null,5,"日数欄"]
[null,null,"　使用予定日数を記載してください。"]
[]
[null,6,"使用備品欄"]
[null,null,"　備品一覧とその総数量をご確認のうえ、使用を希望する備品名をチェックするとともに，その数量を記載してください。"]
[]
[]
[null,7,"エアタイトケース欄"]
[null,null,"　使用を希望する場合は、有　に○をしていただき、展示台（エアタイトケース用）の使用を希望する場合は、その数量を記載してください。"]
[]
[]
[null,8,"その他欄"]
[null,null,"　備品一覧とその総数量をご確認のうえ、その他のパレット柏の共用備品等の使用を希望する場合は、その備品名と数量を記載してください。"]