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[{"$nulls":5},"（西暦）　　　　　年　　　月　　　　日"]
[null,"首都大学東京　学長　殿"]
[]
[null,"既修得単位認定申請書（大学院用）"]
[]
[{"$nulls":4},"申請者：","人間健康科学研究科　博士　　　　　　課程"]
[{"$nulls":5},"　　　　　　　　　　　　　　　　　学域　　　　　年"]
[{"$nulls":5},"学修番号"]
[{"$nulls":5},"氏名"]
[]
[null,"私は、首都大学東京大学院学則第28条に基づき、下記のとおり既修得単位の認定を申請 します。"]
[]
[null,null,"　　　　　　　　　　　　　　　　　　大学院　　　　　　　　　　　　　　　　　　　研究科　　　　　　　　　　　　　　　　　専攻　　　　　"]
[null,null,"（西暦）　　　　年　　　月　　　　日　修了　・　退学　　　　　"]
[{"$nulls":5},"　上段を記入のこと。"]
[null,"◎１時限＝（　　　　）分授業",null,null,null,"下段の※欄は記入しないでください。"]
[null,null,"既修得科目名\n（半期・通年）\n（1コマあたり時間数）","既修単位","授業概要","本学の授業科目名","認定　　　　　　　単位※","認定\n可否※"]
[]
[{"$nulls":5},"学域名※"]
[{"$nulls":5},"認定科目名※"]
[null,1]
[]
[null,null,"（半期・通年）",null,null,"　※"]
[null,null,"（週　　コマ）",null,null,"　※"]
[null,2]
[]
[null,null,"（半期・通年）",null,null,"　※"]
[null,null,"（週　　コマ）",null,null,"　※"]
[null,3]
[]
[null,null,"（半期・通年）",null,null,"　※"]
[null,null,"（週　　コマ）",null,null,"　※"]
[null,4]
[]
[null,null,"（半期・通年）",null,null,"　※"]
[null,null,"（週　　コマ）",null,null,"　※"]
[null,5]
[]
[null,null,"（半期・通年）",null,null,"　※"]
[null,null,"（週　　コマ）",null,null,"　※"]
[]
[null,"注意：　次の書類を添付してください。"]
[null,null,"①既修得科目のシラバス（写）"]
[null,null,"②成績証明書"]