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[{"$nulls":36},"　　　　　年　　　　　月　　　　　日"]
[]
["神戸市民間社会福祉施設職員退職手当共済"]
[]
["職 員 加 入 申 込 書"]
[]
[]
["　社会福祉法人　神戸市社会福祉協議会　理事長　宛"]
[]
["施設番号",{"$nulls":19},"法人名"]
[]
[{"$nulls":20},"施設名"]
[]
[{"$nulls":20},"施設長"]
[]
[]
["　下記のとおり職員の同意を得ましたので、加入を申し込みます。"]
[]
[{"$nulls":42},"※市社協記入欄"]
[]
[]
["　私は、神戸市民間社会福祉施設職員退職手当共済事業規程に同意し、加入を申し込みます。"]
[]
[]
["ﾌﾘｶﾞﾅ"]
[{"$nulls":28},"生年月日（西暦）",{"$nulls":17},"性別"]
[{"$nulls":35},"年",null,null,null,"月",null,null,null,"日",null,null,"男",null,null,null,"女"]
["姓"]
["（漢字）"]
[]
[]
["ﾌﾘｶﾞﾅ"]
[{"$nulls":28},"就職年月日（西暦）",{"$nulls":25},"職名一覧"]
[{"$nulls":35},"年",null,null,null,"月",null,null,null,"日"]
["名",{"$nulls":53},"01","施設長","園長・所長・寮長・院長"]
["（漢字）",{"$nulls":53},"02","指導員","児童指導員・生活指導員（支援員・相談員）・精神障害者社会復帰指導員・ソーシャルワーカー等"]
[{"$nulls":54},"03","保育士","保育士（保母・保父）・児童生活支援員・児童自立支援専門員等"]
[]
[{"$nulls":4},"職種(番号）",{"$nulls":6},"職 名(職名一覧より選択)",{"$nulls":16}," (具体的職名)",{"$nulls":25},"04","介護職員","介護職員・寮母・寮父・ケアワーカー等"]
[{"$nulls":11},"",{"$nulls":16},"(",{"$nulls":12},")",{"$nulls":12},"05","医師","医師等"]
[{"$nulls":54},"06","看護師","看護師・准看護師・保健師等"]
[]
[]
[null,"加入希望年月日（西暦）",{"$nulls":18},"加入時給与月額",{"$nulls":33},"07","訓練指導員","作業指導員・職業指導員・作業療法士・理学療法士・マッサージ師・聴能訓練担当職員・言語機能訓練担当員等"]
[{"$nulls":8},"年",null,null,null,"月",null,null,null,"日",{"$nulls":37},"08","栄養士","栄養士・管理栄養士等"]
[{"$nulls":54},"09","調理員","調理員・調理師等"]
[{"$nulls":54},"10","事務員","事務員・事務長・副施設長・副園長等"]
[{"$nulls":54},"11","介助員","介助員等"]
["※市社協処理欄",{"$nulls":53},"12","ホームヘルパー","ホームヘルパー・世話人等"]
[{"$nulls":54},"13","介護支援専門員","介護支援専門員・ケアマネージャー等"]
[{"$nulls":54},"14","その他","施設長から介護支援専門員までのいずれの職種にも該当しないもの（例:運転手・用務員・薬剤師・守衛・ボイラー技士等）"]
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[{"$nulls":53},"（2021.10）"]