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[]
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["様式第１号"]
[null,"特定子ども・子育て支援施設等確認申請書"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　　年　　月　　日"]
[]
[null,"熊本市長（宛）"]
[]
[null,null,null,null,null,null,null,null,null,null,null,"申請者",null,null,"所在地"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"氏　　　名\n（または名称）　　　　　　　　　",null,null,null,null,null,null,null,null,null,null,"印"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"代表者氏名"]
[]
[null,"　子ども・子育て支援法第３０条の１１の規定による確認を受けたいので、同法第５８条の２に基づき以下のとおり関係書類を添えて申請します。"]
[]
["１．申請者に関する事項"]
[null,"設置主体",null,null,null,null,"法人"]
[null,null,null,null,null,null,null,"国立大学法人",null,null,null,null,"公立大学法人",null,null,null,null,"学校法人",null,null,null,"社会福祉法人"]
[null,null,null,null,null,null,null,"株式会社",null,null,null,null,"ＮＰＯ法人",null,null,null,null,"その他法人"]
[null,null,null,null,null,null,"法人以外"]
[null,null,null,null,null,null,null,"個人",null,null,null,"任意団体"]
[null,"設置者・\n事業者名※"]
[null,"設置者・\n事業者の\n主たる\n事務所の\n所在地",null,null,null,"〒　　　－　　　　"]
[]
[null,null,null,null,null,"TEL：",null,"　　－　　　－　　　　",null,null,null,null,null,null,"ﾒｰﾙｱﾄﾞﾚｽ："]
[null,"代表者",null,null,null,"職名",null,null,null,null,null,null,null,"フリガナ"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"氏名"]
[null,null,null,null,null,"住所",null,null,null,null,null,null,null,null,null,"生年\n月日",null,"昭和\n平成",null,"　　年　　月　　日"]
[null,"※　設置者又は経営者が株式会社、各種法人、任意団体の場合は、社名、法人名、団体名を記入してください。"]
[]
["２．施設・事業に関する事項"]
[null,"施設・事業の\n種類\n",null,null,null,null,null,"認定こども園",null,null,null,null,null,"幼稚園",null,null,null,"特別支援学校幼稚部"]
[null,null,null,null,null,null,null,"認可外保育施設"]
[null,null,null,null,null,null,null,"預かり保育事業（在園児を対象）"]
[null,null,null,null,null,null,null,"一時預かり事業（在園児以外を対象）"]
[null,null,null,null,null,null,null,"病児・病後児保育事業"]
[null,null,null,null,null,null,null,"子育て援助活動支援事業（ファミリー・サポート・センター事業）"]
[null,"事業開始（予定）年月日",null,null,null,"　　　　年　　　月　　　日"]
[]
[null,"（添付書類）"]
[null,null,"１　定款、寄附行為等及びその登記事項証明書等"]
[null,null,"２　役員の氏名、生年月日及び住所の一覧"]
[null,null,"３　法第５８条の１０第２項に規定する申請をすることができない者に該当しないことを誓約する書面"]
[]
[]
[]
[]
[]
[]
[]
["     "]