市立高等学校    音 楽 科 一 日 体 験 入 学 申 込 書
                                                                                                    令和4年     月      日
   名古屋市立菊里高等学校長
        水    野       基       行    様
 
                                                          学校名                        立                             中学校
                                                          校長名
                                                          指導担当者
                                                          所在地
                                                          TEL                                     FAX
 
 
 
        貴校「音楽科一日体験入学¹」（7月9日（土））につき、下記のとおり申し込みます。
 
                                                                                                    専攻実技名（○印を記入）
 
                                     参    加   生   徒   名                 保護者の参加           ピ 管 弦 打 声
                                                                                                                        管弦打楽器
                                                                                                    ア 楽 楽 楽         種別を記入
                                                                                                    ノ 器 器 器 楽
                  ふ り が な
                                                                男・女       保護者参加希望
 
 1 学年      年   氏名                                                   有（1名まで）・    無
 
 
   住所                                                             
                  ふ り が な
                                                                男・女       保護者参加希望
 2 学年      年 氏名                                                     有（1名まで）・    無
 
 
   住所                                                             
                  ふ り が な
                                                                男・女       保護者参加希望
 3 学年      年氏名                                                      有（1名まで）・    無
 
 
   住所                                                             
                  ふ り が な
                                                                男・女       保護者参加希望
 4 学年      年氏名                                                      有（1名まで）・    無
 
 
   住所                                                             
                  ふ り が な
                                                                男・女       保護者参加希望
 5 学年      年氏名                                                      有（1名まで）・    無
 
 
   住所                                                             
                  ふ り が な
                                                                男・女       保護者参加希望
 6 学年      年氏名                                                      有（1名まで）・    無
 
 
   住所                                                             
                  ふ り が な
                                                                男・女       保護者参加希望
 
 7 学年      年氏名                                                      有（1名まで）・    無
 
 
   住所                                                             
 
 
                                           付添教員のある場合…     職名〔           〕氏名〔                            〕
   ※     ご記入いただいたご住所、お電話番号は、この行事の午前・午後の振り分けと緊急時の連絡のためにのみ使用いたします。