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["中国古迹遗址保护协会会员申请登记表  No.(    )"]
[]
["姓名",null,"性别",null,"民族",null,"出生年月"]
["籍贯",null,"出生地",null,"身份证件",null,"证件号码"]
["学术研究领域"]
["专业技术职务",{"$nulls":3},"学历和学位"]
["参加工作时间",{"$nulls":3},"所在党派或团体"]
["现工作单位和职务"]
["通讯地址",{"$nulls":4},"邮编"]
["电话、传真",{"$nulls":3},"电子邮件"]
["学习和工作简历"]
{"$rows_empty":9}
["专业成果"]
{"$rows_empty":10}
[" □    1.本人自愿加入中国古迹遗址保护协会"]
[" □    2.本人已仔细阅读《中国古迹遗址保护协会章程》并愿自觉遵守"]
[" □    3.本人保证以上个人情况属实"]
["本人签名："]
["第1页"]
[]
[]
[]
["中国古迹遗址保护协会会员申请登记表"]
[]
["入会介绍人",null,null,"单位及职务"]
[]
["推荐意见"]
{"$rows_empty":14}
["单位意见"]
{"$rows_empty":9}
["协会意见"]
{"$rows_empty":10}
["填表日期"]
["第2页"]