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[null,"該当するものについて、必ずご確認ください。"]
[null,"◆　年度内の変更事項について（事前報告）　　　　　　　　",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,null,null,null,null,null,null,"□",null,null,"変更予定あり　　　　　"]
[]
[null,null,"年度内に保育が必要な理由（出産・就労・育休等）や家庭状況（転出等）に変更予定がある場合、その内容や時期をお知らせください。"]
[null,null,"変更事項",null,null,null,null,"プルダウンから選択",null,null,null,null,null,null,null,null,null,null,null,null,"内容",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"変更\n時期",null,null,null,null,"年",null,null,"月",null,null,null,"日予定"]
[]
[null,null,"その他連絡事項・詳細について"]
[]
[]
[]
[]
[null,"　□　教育（１号）認定にかかる確認欄",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※下記の内容を確認したら□に☑（チェック）してください。"]
[]
[null,null,"□",null,"【利用時間について】"]
[null,null,"平日8:30～15:00　（土日祝日はお休みですが、園行事のため土曜登園がある場合もあります）"]
[null,null,"※台風等の警報発令時や家庭保育協力日については原則「お休み」となります。"]
[null,null,"□",null,"【預かり保育（定期利用）について】",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（","□","）利用予定あり　※申請は別に必要です。"]
[null,null,"利用時間を延長し（15:00～16:00）、月単位で保育利用することができます。月額利用料3,000円（日割りなし）。"]
[null,null,"利用するには申請が必要です。利用開始前に園へ申請書をご提出ください。"]
[null,null,"□",null,"【預かり保育（長期休業利用）について】",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（","□","）利用予定あり　※申請は別に必要です。"]
[null,null,"１号認定児は原則、長期休業があります（年度始休業、夏季休業、冬季休業、年度末休業）。"]
[null,null,"ただし、保育が必要な場合、申請を行うことで応益負担により保育利用（平日8:30～16:00）も可能です。日額利用料1,000円。"]
[]
[]
[null,"　□　保育（２・３号）認定にかかる確認欄",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※下記の内容を確認・記入したら□にチェックしてください。"]
[]
[null,null,"□",null,"【利用調整について】"]
[null,null,"年度内において保育認定を受け、保育施設を利用中（予定）であっても、年度途中で保育の必要性の高い他の児童の入園希望があり、"]
[null,null,"また該当クラスが定員数を超える場合、入園または在園継続についてご相談させていただくことがあります（対象は保育の必要性の低い"]
[null,null,"（調整点数の低い）ご家庭となります）。公平な運用のためとなりますので、ご理解ご協力をお願いします。"]
[]
[null,null,"□",null,"【親族の状況について】　※祖父母と連絡が取れない場合は不明と記入し、死亡の場合は斜線を引いてください。"]
[null,null,null,"児童からの続柄",null,null,null,null,null,"氏　名",null,null,null,null,null,null,null,"年齢",null,null,"就労",null,null,"保育協力",null,null,null,"世帯",null,null,null,"別居の場合、住所記載（都道府県・市町村名まで可）"]
[null,null,"父方","祖父",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"無",null,null,"無",null,null,null,"同/別"]
[null,null,null,"祖母",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"無",null,null,"無",null,null,null,"同/別"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"無",null,null,"無",null,null,null,"同/別"]
[null,null,"母方","祖父",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"無",null,null,"無",null,null,null,"同/別"]
[null,null,null,"祖母",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"無",null,null,"無",null,null,null,"同/別"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"無",null,null,"無",null,null,null,"同/別"]
[]
[]
[null,null,"※那賀町使用欄"]
[null,null,"◆　特記事項"]
[]
[null,null,"◆　利用調整（点数）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※申込数が利用定員を超過した場合、下表にて利用調整を行うことがあります。"]
[null,null,"父母表",null,null,"保育が必要な理由",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"父",null,"母",null,null,"優先利用項目表（１項目につき10点）"]
[null,null,"就労",null,null,"就労時間が月120時間程度",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,10,null,10,null,null,null,"優先利用項目"]
[null,null,null,null,null,"就労時間が月48時間以上",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,5,null,5,null,null,1,"ひとり親等家庭"]
[null,null,null,null,null,"内職",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,4,null,4,null,null,2,"生活保護家庭"]
[null,null,"出産",null,null,"妊娠・出産（産前産後）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,10]
[null,null,null,null,null,"産後延長",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,5,null,null,"加点表（１事由につき1点）"]
[null,null,"疾病\n負傷\n障がい",null,null,"保護者の疾病・負傷（入院）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,10,null,10,null,null,null,"事　　由"]
[null,null,null,null,null,"保護者の疾病・負傷（自宅療養）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,7,null,7,null,null,1,"昨年度の入園申込時に、定員超過理由により他のこども園に調整した子どもで、本年度も同じこども園を希望する場合"]
[null,null,null,null,null,"保護者の障がい（身体1・2級、療育A、精神1級）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,10,null,10]
[null,null,null,null,null,"保護者の障がい（身体3級、療育B、精神2級）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,9,null,9,null,null,2,"すべての祖父母が町外在住（又は不在）の場合"]
[null,null,"介護\n看護",null,null,"自宅介護･看護及び付き添い通所",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,7,null,7]
[null,null,null,null,null,"入院中の介護・看護",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,3,null,3,null,null,null,null,null,null,null,null,null,null,null,null,"調整日",null,null,null,null,"年",null,null,"月",null,null,"日"]
[null,null,"災害等",null,null,"災害復旧、DV被害",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,10,null,10,null,null,"父",null,"点",null,null,"優先\n利用",null,"点",null,null,"加点",null,"点",null,null,"合計　　　　　　　点"]
[null,null,"不在",null,null,"保護者の不在（単身赴任、別居等）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,10,null,10,null,null,"母",null,"点"]
[null,null,"就学",null,null,"大学、専門学校等での就学・職業訓練",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,7,null,7,null,null,"経過",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"処理者"]
[null,null,"育休",null,null,"育休継続1年目",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,5,null,5]
[null,null,null,null,null,"育休継続2年目",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,1,null,1]
[null,null,"求職",null,null,"求職活動",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,1,null,1]