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["受講申込書（Application Form）"]
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["クラス名"]
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["Visa Status"]
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["住所"]
["Address in Japan"]
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["本国住所"]
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["母語",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"他の習得外国語"]
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["日本語学習経験",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"YES",null,null,null,null,null,"NO",null,null,null,null,null,null,null,"教育機関名あるいは独習"]
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["学習期間、時間数/週\n"]
["Periods, Hours/Week"]
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["使用教科書名"]
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[]
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["備　考："]