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["茨木映像芸術祭 応募様式"]
[]
[]
["以下に必要事項を記入し、映像ファイルと共に提出してください"]
[]
[]
["ふりがな"]
["代表者氏名"]
["住所",null,null,null,"〒",null,null,null,"-"]
[]
[]
["年齢",{"$nulls":13},"生年月日",{"$nulls":6},"年",null,null,"月",null,null,"日"]
["電話番号",{"$nulls":13},"携帯番号"]
[]
["メールアドレス"]
[]
["団体の場合：構成員及び年齢\n",null,null,null,"団体名"]
[{"$nulls":4},"氏名・年齢"]
[]
["ふりがな"]
["作品タイトル"]
[]
["作品時間",{"$nulls":6},"分",null,null,null,"秒"]
["制作年月日",{"$nulls":6},"年",null,null,null,"月"]
["著作権者名"]
["作品について(200字程度)"]
[]
[]
[]
[]
["本芸術祭をどこで知りましたか",null,null,null,"　１　 広報物　　2　 webサイト　　３　その他（　　　　　　　　　　　　　　）"]
[]
[]
[null,"茨木映像芸術祭リーフレット及びHPに記載の注意事項等に同意します。"]
[]
[{"$nulls":21},"事務局使用欄"]
[{"$nulls":21},"受付日"]
[{"$nulls":21},"受付番号"]