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["後志管内公立小中学校臨時教員等志願書",{"$nulls":9},"平成　　年　　月　　日"]
["ﾌﾘｶﾞﾅ",{"$nulls":7},"性別",null,"年齢","\n\n写真\n\n\n上半身　脱帽\n\n正面向き\n\n　横　3．5㎝\n　縦　4．5㎝　"]
["氏名",{"$nulls":7},"男 ・ 女"]
["（生年月日）"]
["現住所","〒"]
[]
["TEL",{"$nulls":4},"Email\n-address"]
["携帯"]
["固定"]
["所有\n免許状","免許の種類","（例）中学校１種（国語）",{"$nulls":8},"得意教科（科目）"]
[null,"番号","平○○中一第○○○○号"]
[null,"取得年月日","平成○○年○○月○○日"]
[null,"更新期限","平成○○年○○月○○日"]
["資格等"]
["勤務\n可能期間",null,null,"～",{"$nulls":4},"希望職種",null,"教諭・養護教諭・その他（　　　　）"]
["希望校種\n及び学級","小学校",null,"中学校",null,null,"どちらでも可",null,"普通学級",null,"特別支援学級",null,"どちらでも可"]
["希望教科"]
["志望動機"]
["指導できるクラブ活動",{"$nulls":5},"特技\n（段・級、\n実績等）"]
[]
["勤務地","　　どこでも良い",{"$nulls":7},"その他勤務に関する要望"]
["※　どちらかを\n  ○で囲むこと。\n　　勤務地を限\n  定する場合は\n  理由及び希望\n  勤務地を記入\n  すること。","　　\n　　勤務地限定\n\n　　希望勤務地及び理由"]
["身体状況","耳疾",null,"有（　  　　）",null,null,"・","無","身体障害",null,"有　・　無"]
[null,"既往症及び現症",null,"有（　　  　）",null,null,"・","無","障害名"]
[null,"視力",null,"裸眼","右",null,"左",null,"障害者手帳",null,"有　・　無"]
[null,null,null,"矯正",{"$nulls":4},"障害の程度"]
["扶養家族（配偶者除く）",null,null,"配偶者",null,null,"有　・　無",null,null,"配偶者の扶養義務",null,null,"有　・　無"]
[]
["選考検査\n受検","受検年度","受検地",null,"受検区分",null,null,null,"受検番号"]
["有・無"]
[]
["注　教員採用候補者選考検査を受検したことがある者は、上記項目を記入すること。"]
["　　（昨年度以前の受検である場合は、受検番号の記入は要しない。）"]

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["学　　　歴"]
["在学期間",null,null,null,"学校名",null,"学部・学科名",null,"学年","卒業等の別"]
[{"$nulls":4},"小学校",null,null,null,"年","卒業"]
[null,null,"～",null,"中学校",null,null,null,"年","卒業"]
[null,null,"～",null,"高等学校",null,null,null,"年"]
[null,null,"～",{"$nulls":5},"年"]
[null,null,"～",{"$nulls":5},"年"]
[null,null,"～",{"$nulls":5},"年"]
[]
["職　　　歴"]
["期　間",null,null,null,"勤務先",{"$nulls":4},"職名"]
[null,null,"～"]
[null,null,"～"]
[null,null,"～"]
[null,null,"～"]
[null,null,"～"]
[null,null,"～"]
[null,null,"～"]
[null,null,"～"]
[null,null,"～"]
[null,null,"～"]
[null,null,"～"]
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[null,null,"～"]
[null,null,"～"]
[null,null,"～"]
[null,null,"～"]
[null,null,"～"]
[null,null,"～"]
[]
["　教員を退職した者で経歴の長い者については、例えば「平成７年４月１日～平成18年３月31日○○高等学校\n他４高等学校、１特別支援学校　教諭」のように職名ごとに勤務期間・勤務校を省略して記入してもよい。\n　ただし、その場合でも、最終勤務学校については、欄を区別し勤務期間、勤務校及び職名を記入すること。"]
[]
["　"]