9/6~11/15 にほんごきょうしつ10回コース(入門・初級)申し込み/inscrição para o curso de japonês (leitura/escrita e principiante)/application for Japanese cource(read & write, biginner)
半田国際交流協会 TEL: 0569-26-1929 e-mail: hia@poplar.ocn.ne.jp

↓ メールアドレス(めーるあどれす/endereço eletrônico/e-mail)
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名前(なまえ/nome/name) *
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性別(せいべつ/sexo/gender) *
生年月日(せいねんがっぴ/data de nascimento/date of birth) *
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住所(じゅうしょ/endereço/address) *
電話番号(でんわばんごう/telefone/tel) *
会社の名前(かいしゃのなまえ/nome da firma/place of work)
会社の電話番号(かいしゃのでんわばんごう/telefone da firma/phone number at place of work)
受けたいクラス(うけたいくらす/nível que quer cursar/the level you want to take) *
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