作業員名簿・Contact information
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Email *
ギリ　プラン *
職種（Job type）わからない時は雑工 if you dont know, select other else *
Required
年齢・Age *
埼玉県久喜市菖蒲町新堀590-1 *
1994/08/08 *
MM
/
DD
/
YYYY
緊急連絡先・emergency contact(name, phone, address) :09035608940 *
健康保険（下4桁）Helth Insurance card(Last 4 number)if you dont have, write "nil" : nil *
免許・Lincense *
Required
電話番号・Mobile number : 09035608940
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