No. 港区国際交流スペース集会室利用申込書 Year: Month: Day: Name

No.
第 6 号様式 (第 10 条関係 )
港区国際交流スペース集会室利用申込書
Application for Minato International Communication Space Meeting Room Reservation
Year:
Month:
Day:
To the Mayor of Minato City
Registration number of the Applicant 登録番号 #
Name of the Group
Address
Name of the representative
Tel:
I will apply for the room as shown in the table below
Intention to use the room
The
Contents of reservations
Date
Year・
Day of the
Month・Day
week
・
・
・
・
・
・
・
・
Name of the person
in charge
Room
Number
number
of
Equipments
Hours
（Put mark on the ones you
use）
people
Room1
Room2
Room1
Room2
Room1
Room2
Room1
Room2
Name
From
To
From
To
From
To
From
To
S c r e e n , p r o je c t o r ,
TV,ＤＶＤ/video player
s c r e e n , p r o je c to r ,
TV,ＤＶＤ/video player
S c r e e n , p r o je c t o r ,
TV,ＤＶＤ /video player
S c r e e n , p r o je c t o r ,
TV,ＤＶＤ/video player
Tel:
Remarks
課長
係長
担当
受付

Download Report