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ポスター掲示 協力連絡
関西若手議員ネットワーク(寺坂よしかず)のポスター掲示の協力用のフォームです。
下記にご記入頂き、お申し込みをお願いします。
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Email
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Your email
姓
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Your answer
名
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Your answer
姓(ふりがな)
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Your answer
名(ふりがな）
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Your answer
郵便番号
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Your answer
掲示場所(「尼崎市」以降をご記入下さい)
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Your answer
電話番号
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Your answer
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