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["（様式 4）",{"$nulls":7},"本日の値が入力されます．\n任意の日付入力はこちらへ"]
["２０１６年　６月　３０日"]
[]
["九州大学農学部附属演習林\n　　演習林長　　殿"]
[{"$nulls":8},"各演習林名",null,null,null,"福岡"]
[null,null,"大学・機関・企業名",{"$nulls":9},"宮崎"]
[null,null,"（研究院，学部，研究科名）",{"$nulls":9},"北海道"]
[null,null,"（部門，学科名）"]
[null,null,"（講座・分野名）"]
[null,null,"郵便番号"]
[null,null,"住　所"]
[null,null,"電　話"]
[null,null,"利 用 者 名"]
[null,null,"（指導教員名）　　　　　　　　　",null,null,"＊利用者が学生の場合"]
[null,null,"E-mail"]
["大型試料採取申請書"]
["このことについて，下記のとおり大型試料提供をお願いしたいので，申請いたします.    "]
["記"]
["１．教育・研究題目"]
["２．樹種名"]
["３．数量・規格"]
[]
["４．採取場所",null,null,"演習林"]
[null,null,null,"林班      ","小班"]
["５．提供希望時期"]
[null,null,"　　　　　年　　　　月"]
["６．諸経費の負担"]
[]
["　 ７．研究目的",null,"（卒業研究，修士研究，博士研究，その他）該当箇所を〇で囲む"]
["（内　容）"]
["８．採取後の処理"]
[]
["　 ９．その他"]
["   10．演習林からの要請"]
[]
["       1.研究成果は得られ次第，研究部調査室に提出して下さい．"]
[0,"演習林長","調査室長","技術室長",null,"森林管理委員長（研究部長）","演習林長    許可印\n"]
[{"$nulls":5},"許可印"]
[]
[]
[]
[]
[{"$nulls":4},"受付"]
[{"$nulls":4},"承認"]

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["（様式10）"]
["試　験　地　申　請　位　置"]
["１．目的"]
[]
["２．方法"]
[]
["(位置図)1/5000地形図と位置情報を記載"]
[]
["中心地位置情報"]
["（緯度                      ）"]
["（経度                      ）"]