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[{"$nulls":7},"（様式３）"]
[{"$nulls":7},"令和　　年　　月　　日"]
[null,"独立行政法人国立美術館"]
[null,"国立映画アーカイブ館長　殿"]
[]
[]
[{"$nulls":5},"公立文化施設等長"]
[{"$nulls":5},"氏 名",null,"㊞"]
[]
[]
["令和8年度優秀映画鑑賞推進事業実施報告書"]
[]
[null,"このことについて、下記のとおり報告します。"]
[]
["記"]
[]
["１ 概要"]
[null,"(1)","実施会場名","：",null,null,null,"　"]
[]
[{"$nulls":4},"都道府県",null,"市町村"]
[]
[null,"(2)","実施プログラム名","：",null,"プログラム"]
[]
[null,"(3)","実施期間","：","令和　　年　　月　　日（　　）　～　　月　　日（　　）"]
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[{"$nulls":4},"合計　　　　　","日間"]
[]
[null,"(4)","担当者名","：",null,null,null,"　"]
[null,null,"連絡先ＴＥＬ","："]
[null,null,"メールアドレス","："]
[]
[null,"(5)","当事業の実施回数","：","合計　　　　　","回（本年度を含む）"]
[]
[null,"(6)","入場者数","：","　"]
[null,"上映作品名",null,null,null,"上映回数(回）","入場者数(人）","１回平均\n入場者数(人）"]
[]
[null,1]
[null,2]
[null,"全作品計",null,null,null,"上映回数合計","入場者数合計","1回平均入場者数"]
[{"$nulls":5},"　","　"]
[]
[{"$nulls":5},1]

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["２ 事業記録"]
[]
["(1)入場者数","（注）","入場者数の記載にあたっては、1回の上映ごとに入替制を行ったものとみなして入場者数を算出するものとする。"]
[]
["上映作品名",null,"上映日","上映時間","入場者数（人）"]
[1,null,"　月　　日","　　　時　　　分　～　　　時　　　分","　"]
[null,null,"　月　　日","　　　時　　　分　～　　　時　　　分"]
[null,null,null,"小計"]
[null,null,null,"１回平均"]
[2,null,"　月　　日","　　　時　　　分　～　　　時　　　分"]
[null,null,"　月　　日","　　　時　　　分　～　　　時　　　分","　"]
[null,null,null,"小計"]
[null,null,null,"１回平均"]
["計",null,"上映日数合計","延べ上映回数","１回平均入場者数"]
[null,null,"日","　　　　　　回","　　　　人"]
[]
["(2)収支決算"]
["収　　　入",null,null,"支　　　出　"]
["事　　項",null,"金　額","事　　項","金　額"]
[null,null,"円",null,"円"]
["①事業費",null,null,"①フィルム・DCP往復送料"]
["②観覧料",null,null,"②広報紙印刷費"]
["③補助金",null,null,"③観覧券印刷費"]
["④その他",null,null,"④会場使用料"]
[null,null,null,"⑤会場設営費（映写機借上代含）"]
[null,null,null,"⑥映写技師経費"]
[null,null,null,"⑦会場整理要員費"]
[null,null,null,"⑧実行委員会に要した経費"]
[null,null,null,"⑨その他"]
[]
["計",null,0,"計",0]
[]
[null,null,null,2]

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[]
["　３　アンケート集計結果 　※実施日が数日ある場合、まとめたデータを記入してください"]
[]
[null,"総入場者数",null,null,null,"　　　　名","提出数","　　　　名","回答率","　　　　　％"]
[]
[null,1,null,"年齢・性別・住所"]
[{"$nulls":4},"①性別　","男性","　　　　名","女性","　　　　名","その他","　　　　名"]
[{"$nulls":5},"回答しない","　　　　名","無回答","　　　　名"]
[]
[{"$nulls":4},"②年齢","９歳以下","　　　　名","１０代","　　　　名","２０代","　　　　名"]
[{"$nulls":5},"３０代　　","　　　　名","４０代","　　　　名","５０代","　　　　名"]
[{"$nulls":5},"６０代　　","　　　　名","７０歳以上","　　　　名","　　回答しない　 ","　　　　名"]
[{"$nulls":5},"　　無回答　 ","　　　　名"]
[]
[{"$nulls":4},"③住所","会場のある市町村","　　　　名","近隣の地域","　　　　名","その他","　　　　名"]
[{"$nulls":5},"　 無回答","　　　　名"]
[]
[null,2,null,"どなたとご鑑賞"]
[{"$nulls":5},"一人","　　　　名","友人・知人","　　　　名","家族","　　　　名"]
[{"$nulls":5},"その他","　　　　名","無回答","　　　　名"]
[]
[null,3,null,"情報入手方法"]
[{"$nulls":5},"広報誌　",null,"　　　　名",null,"ポスター・チラシ","　　　　名"]
[{"$nulls":5},"知人・口コミ　",null,"　　　　名",null,"インターネット・SNS","　　　　名","　"]
[{"$nulls":5},"その他（具体的に）　",null,"　　　　名",null,"無回答","　　　　名"]
[]
[null,4,null,"優秀映画鑑賞回数"]
[{"$nulls":4},"初めて（1回目）","　　　　名","２～５回目","　　　　名","６～１０回","　　　　名"]
[{"$nulls":4},"それ以上","　　　　名","無回答","　　　　名"]
[]
[null,5,null,"１年間の映画鑑賞回数"]
[{"$nulls":4},"➀【映画館やホール】"]
[{"$nulls":4},"０本","　　　　名"," １～２本","　　　　名","３～５本","　　　　名","　"]
[{"$nulls":4},"６～１０本","　　　　名","それ以上","　　　　名","無回答","　　　　名"]
[]
[{"$nulls":4},"➁【ビデオやＤＶＤ】"]
[{"$nulls":4},"０本","　　　　名"," １～２本","　　　　名","３～５本","　　　　名"]
[{"$nulls":4},"６～１０本","　　　　名","それ以上","　　　　名","無回答","　　　　名","　"]
[]
[{"$nulls":4},"➂【テレビ】"]
[{"$nulls":4},"０本","　　　　名"," １～２本","　　　　名","３～５本","　　　　名"]
[{"$nulls":4},"６～１０本","　　　　名","それ以上","　　　　名","無回答","　　　　名"]
[{"$nulls":10},"　"]
[{"$nulls":4},"④【インターネット（動画配信などを含む）】"]
[{"$nulls":4},"０本","　　　　名"," １～２本","　　　　名","３～５本","　　　　名"]
[{"$nulls":4},"６～１０本","　　　　名","それ以上","　　　　名","無回答","　　　　名"]
[]
[null,6,null,"感想"]
[{"$nulls":4},"全体としてよかった","　　　　名","全体としてよくなかった",null,"　　　　名"]
[{"$nulls":4},"どちらとも言えない","　　　　名","無回答","　　　　名"]
[]
[null,7,null,"添付資料 "]
[{"$nulls":4},"※ポスター、チラシ、入場券、その他事業を実施する上で作製された印刷物等を添付してください。"]
[]
[null,8,null,"意見・感想等"]
[{"$nulls":4},"※実施担当者の意見・感想等のほか、アンケートの自由記述欄の主な意見・感想等も記載してください。必要に応じて別紙を作成願います。"]
[]
[]
[null,9,null,"本事業の今後の参考とするため、①実施会場における、年間の映画上映回数と種類（自主事業及び施設利用、貸館事業含む）、②実施会場を利用している名画鑑賞会等の映画上映活動が地域にあればその名称、③上記①のデジタル上映時に使用されたメディア（該当するものに○）を記載してください。"]
[]
[]
[null,null,null,"①","【自主事業】フィルム　　回／デジタル　　回　　【貸館事業】フィルム　　回／デジタル　　回　"]
[null,null,null,"②","名画鑑賞会名"]
[null,null,null,"③","デジタル上映時の使用メディア（DCP／Blu-ray／DVD／その他（　　　　））"]
[{"$nulls":4},"＊該当するものに〇を付けてください"]