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["                ","东方今报小记者俱乐部入会登记表",null,null,"    "]
["编号：",{"$nulls":3},"年  月  日"]
["姓   名",null,"性    别",null,"请附二张小一寸相片"]
["生   日",null,"籍    贯"]
["学   校",null,"班    级"]
["E-mail",null,"QQ"]
["星   座",null,"爱    好"]
["偶   像"]
["获奖记录"]
["你的梦想"]
["家庭地址",null,null,"邮编"]
["家长姓名",null,"工作单位"]
["手    机",null,"家长同意签名"]
["对孩子的期望"]
["                    以下内容由指导老师填写"]
["指导老师",null,"办公电话"]
["手    机",null,"QQ"]
["对孩子的期望"]
["备    注"]

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