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["別記様式第１号（第３条関係）"]
["延　長　保　育　申　込　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,null,null,null,null,null,null,null,null,"月希望"]
["※私立保育園の延長保育は、在園(内定先)の私立保育園に直接お申し込みください。"]
[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,"日付"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"保護者",null,null,"住　所",null,null,"〒　 　－",null,null,null,"-"]
["文京区長",null,null,null,null,null,null,null,null,"殿",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,"文京区 町名 〇丁目〇番〇－〇号"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"\n氏　名",null,null,"①"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"②"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"電　話"]
[]
[null,"児童名",null,null,null,null,null,null,null,null,null,null,null,null,"生年月日",null,null,null,null,null,null,null,"年齢",null,null,"申請・在園状況",null,null,null,null,null,null,null,null,null,null,null,"2023-04-01"]
[]
["１",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(O13=\"\",\"\",IFERROR(DATEDIF(O13,DATE(2025,4,1),\"y\"),0))","v":""},null,null,"（　　入園　　転園　）申請中",null,null,null,null,null,null,null,null,null,null,null,false,false,{"$f":"IF(COUNTIF(AL13:AM13,TRUE)=1,2,1)","v":1},{"$f":"IF(AND(AN13=1,AA14=\"\"),1,2)","v":1}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,null,null,null,"）在園"]
["2",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(O15=\"\",\"\",IFERROR(DATEDIF(O15,DATE(2025,4,1),\"y\"),0))","v":""},null,null,"（　　入園　　転園　）申請中",null,null,null,null,null,null,null,null,null,null,null,false,false,{"$f":"IF(COUNTIF(AL15:AM15,TRUE)=1,2,1)","v":1},{"$f":"IF(AND(AN15=1,AA16=\"\"),1,2)","v":1}]
[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,"）在園"]
["3",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(O17=\"\",\"\",IFERROR(DATEDIF(O17,DATE(2025,4,1),\"y\"),0))","v":""},null,null,"（　　入園　　転園　）申請中",null,null,null,null,null,null,null,null,null,null,null,false,false,1,1]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,null,null,null,"）在園"]
["[申込理由] "]
[null,null,null,"　　正規の勤務時間で間に合わないため　 　　 現在残業があるため　 　　今後残業予定のため",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,false,false,false,false,{"$f":"IF(COUNTIF(AL20:AP20,TRUE)>0,2,1)","v":1}]
[null,null,null,"　　育児短時間制度が終了する予定であるため",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　　その他",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(AND(AP20=TRUE,Y21=\"\"),1,2)","v":2}]
[]
[" ［転園申込者のみ]"]
[null,null,null,"　  転園先の園でのみ延長保育を希望する。　　 　   在園中の園でのみ延長保育を希望する。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,false,false,{"$f":"IF(COUNTIF(AL24:AN24,TRUE)=1,2,1)","v":1}]
[null,null,null,"　  転園先の園で延長を希望する。転園保留の場合は在園中の園でも延長保育を希望する。"]
[]
["　[同じ園に申請（在園）中の児童が同時に２人以上申込みをする方のみ]"]
[null,null,null,"申込児童が同時に延長保育を利用できない場合"]
[null,null,null,"　　ひとりだけでも延長保育を希望する　　　　　　　　　 希望しない",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,false,false,{"$f":"IF(COUNTIF(AL29:AM29,TRUE)=1,2,1)","v":1}]
[]
[null,null,null,null,null,"保護者①の状況（児童との続柄：",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"）","保護者②の状況（児童との続柄：",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"）"]
["保護者名"]
["勤務先"]
["所在地"]
["電話番号"]
["正規の勤務時間等（※１※２）",null,null,null,null,"週",null,null,null,"日",null,null,null,null,null,"～",null,null,null,null,null,"週",null,null,null,"日",null,null,null,null,null,"～"]
["職場から保育園までの所要時間",null,null,null,null,null,null,null,"分",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"分"]
["所要時間経路\n（職場から保育園までのお迎え経路をご記入ください。)",null,null,null,null,"勤務先",null,null,null,null,null,null,null,null,null,null,"保育園",null,null,null,null,"勤務先",null,null,null,null,null,{"$f":"IF(L38=\"\",\"\",L38)","v":""},null,null,null,null,"保育園"]
[null,null,null,null,null,"【通勤経路】",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"【通勤経路】"]
[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,null,null,null,null,"会社　→　a駅　→\n  （徒歩〇分）（乗車〇分）\nb駅　→　c駅　→　d駅　→　保育園\n（乗車〇分）（乗車〇分）"]
[null,null,null,null,null,"※所要時間経路について申し添えることがある場合（※３）は、別紙を別添可",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※所要時間経路について申し添えることがある場合（※３）は、別紙を別添可"]
["育児短時間勤務利用中の場合",null,null,null,null,"週",null,null,null,"日",null,null,null,null,null,"～",null,null,null,null,null,"週",null,null,null,"日",null,null,null,null,null,"～"]
["育児短時間勤務\n終了予定日"]
[]
["※１　退勤時間の詳細が分かる資料のご提出をお願いすることがあります。\n※２　裁量労働制及びフレックスタイム制の方は、主な勤務時間をご記入ください。\n※３　勤務先が複数ある、在宅勤務をする日がある、複数の区立認可保育所等に申し込む、きょうだいが別の園に通園している等の理由により、大きく所要時間経路が変わる場合等"]
[]
["【区立認可保育所に在園されている場合のみご記入ください。】"]
[null,null,null,null,null,"週３日以上、延長保育の利用時間帯（午後６時１５分から午後７時１５分まで）に有料で他の保育サービス等の有無",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"提出書類"]
["受託",null,null,null,null,"　　なし　　あり",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," 　受託証明書\n  （区立認可保育所月極延長保育用）",null,null,null,null,null,null,null,null,null,null,null,null,null,false,false,{"$f":"IF(COUNTIF(AL49:AM49,TRUE)=1,2,1)","v":1}]
[]
["【該当する場合のみご記入ください。】"]
[null,null,null,null,null,"申込児以外のきょうだいの私立認可保育所（地域型保育事業を含む）における月極の延長保育の利用の有無",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"提出書類"]
["多子②",null,null,null,null,"　　なし　　あり",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," 　受託証明書\n  （区立認可保育所月極延長保育用）",null,null,null,null,null,null,null,null,null,null,null,null,null,false,false,{"$f":"IF(COUNTIF(AL53:AM53,TRUE)=1,2,1)","v":1}]
[]
["【以下については、保育所と同時申請であれば、ご記入は不要です。】"]
[null,null,null,null,null,"↓○を付けて、あり・該当の場合は（　）内を記載",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"提出書類"]
["出産予定",null,null,null,null,"　　なし　　あり",null,null,null,null,null,"出産予定日",null,null,null,null,null,null,null,null,null,null,null," 　母子手帳のコピー\n　（表紙と出産予定日の分かるページ）",null,null,null,null,null,null,null,null,null,null,null,null,null,false,false,{"$f":"IF(COUNTIF(AL57:AM57,TRUE)=1,2,1)","v":1},{"$f":"IF(AND(AM57=TRUE,Q57=\"\"),1,2)","v":2}]
["ひとり親家庭",null,null,null,null,"　　非該当　　　該当",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," 　ひとり親の家庭状況申告書\n　（内容により戸籍謄本等必要）",null,null,null,null,null,null,null,null,null,null,null,null,null,false,false,{"$f":"IF(COUNTIF(AL58:AM58,TRUE)=1,2,1)","v":1}]
[]
["祖父母の状況",null,null,"氏名",null,null,null,null,null,"年齢(生年月日)",null,null,null,null,null,null,"住所",null,null,null,null,null,null,null,null,null,null,"祖父母の状況",null,null,null,null,null,null,null,"不存在"]
[null,"保護者①","祖父",null,null,null,null,null,null,{"$f":"IF(M61=\"\",\"\",IFERROR(DATEDIF(M61,TODAY(),\"y\"),0))","v":""},null,"歳",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"就労",null,null,"無職",null,null,null,null,null,false,false,false,false,false,{"$f":"IF(AND(AP61=FALSE,D61=\"\"),1,2)","v":1},{"$f":"IF(AND(AP61=FALSE,M61=\"\"),1,2)","v":1},{"$f":"IF(AND(AP61=FALSE,Q61=\"\"),1,2)","v":1},{"$f":"IF(AND(J61<65,COUNTIF(AL61:AO61,TRUE)<1),1,2)","v":2}]
[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,"介護",null,null,"疾病"]
[null,null,"祖母",null,null,null,null,null,null,{"$f":"IF(M63=\"\",\"\",IFERROR(DATEDIF(M63,TODAY(),\"y\"),0))","v":""},null,"歳",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"就労",null,null,"無職",null,null,null,null,null,false,false,false,false,false,{"$f":"IF(AND(AP63=FALSE,D63=\"\"),1,2)","v":1},{"$f":"IF(AND(AP63=FALSE,M63=\"\"),1,2)","v":1},{"$f":"IF(AND(AP63=FALSE,Q63=\"\"),1,2)","v":1},{"$f":"IF(AND(J63<65,COUNTIF(AL63:AO63,TRUE)<1),1,2)","v":2}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"介護",null,null,"疾病"]
[null,"保護者②","祖父",null,null,null,null,null,null,{"$f":"IF(M65=\"\",\"\",IFERROR(DATEDIF(M65,TODAY(),\"y\"),0))","v":""},null,"歳",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"就労",null,null,"無職",null,null,null,null,null,false,false,false,false,false,{"$f":"IF(AND(AP65=FALSE,D65=\"\"),1,2)","v":1},{"$f":"IF(AND(AP65=FALSE,M65=\"\"),1,2)","v":1},{"$f":"IF(AND(AP65=FALSE,Q65=\"\"),1,2)","v":1},{"$f":"IF(AND(J65<65,COUNTIF(AL65:AO65,TRUE)<1),1,2)","v":2}]
[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,"介護",null,null,"疾病"]
[null,null,"祖母",null,null,null,null,null,null,{"$f":"IF(M67=\"\",\"\",IFERROR(DATEDIF(M67,TODAY(),\"y\"),0))","v":""},null,"歳",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"就労",null,null,"無職",null,null,null,null,null,false,false,false,false,false,{"$f":"IF(AND(AP67=FALSE,D67=\"\"),1,2)","v":1},{"$f":"IF(AND(AP67=FALSE,M67=\"\"),1,2)","v":1},{"$f":"IF(AND(AP67=FALSE,Q67=\"\"),1,2)","v":1},{"$f":"IF(AND(J67<65,COUNTIF(AL67:AO67,TRUE)<1),1,2)","v":2}]
[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,"介護",null,null,"疾病"]
[null,"※","同居又は近隣在住（保護者住所地から半径５００メートル以内）の祖父母で６５歳未満の方については、保育の援助ができないことを証明する書類（就労証明書・介護状況申告書・診断書等）の提出が必要です。"]
[]
[]
["幼児保育課欄　　窓口（父・母・　　　）受付（　　　　）／　郵送　／　夜間Ｐ　",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,"NO."]