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[]
[]
[null,null,null,"a) Kontaktdaten ANTRAGSTELLER (Zahlungspflichtiger)"]
[]
[null,null,null,"Nachname",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"*",null,"*",null,"Ich bin",null,"Namenszusatz / Titel"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"erziehungs-\nberechtigt"]
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[null,null,null,"Vorname",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"*",null,"Männl.","M","W","Weibl.","Geb.Datum",null,null,null,null,null,null,null,"*"]
[]
[]
[null,null,null,"Straße + Hausnummer",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"*",null,"Telefon",null,null,null,null,null,null,null,null,null,null,null,"*"]
[]
[]
[null,null,null,"Postleitzahl + Ort",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"*",null,"Email",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"*"]
[]
[]
[]
[]
[null,null,null,"An den "]
[null,null,null,"Freundeskreis Hannah-Arendt-Gymnasium Haßloch e.V."]
[null,null,null,"Vorstandsvorsitzender",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"*","  Angabe Pflicht"]
[null,null,null,"Viroflayer Straße 20",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"#","  Angabe empfohlen"]
[null,null,null,"67454 Haßloch"]
[]
[]
[null,null,null,"Ja, ich beachte als Antragsteller die Zuschuss-Richtlinien d. Freundeskreises (gem. akt. Merkblatt) und stelle hiermit den "]
[]
[null,null,null,"Antrag auf Bezuschussung einer HAG-Schülerfahrt"]
[]
[null,null,null,"Ohne eine Bezuschussung in u.g. Bedarfshöhe ist die Teilnahme an der Fahrt"]
[null,null,null,null,"gefährdet",null,null,null,null,"erheblich gefährdet",null,null,null,null,null,null,null,null,"nicht möglich.",null,null,null,null,null,"(Zutreffendes ankreuzen)",null,null,null,null,null,null,null,null,null,null,"Freundeskreis-Vermerke"]
[]
[null,null,null,"b) Angaben zur/m zu unterstützende/n SCHÜLER/IN",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Eingang"]
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[null,null,null,"Nachname",null,null,null,null,null,null,null,null,null,null,null,null,null,"*",null,"Klassenleiter(in)",null,null,null,null,null,null,null,null,null,null,null,null,null,"*",null,"wann:"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"wo:"]
[]
[null,null,null,"Vorname",null,null,null,null,null,null,null,null,null,null,null,null,null,"*",null,"Männl.","M","W","Weibl.","Geb.Datum",null,null,null,null,null,"*",null,"Klasse",null,"*",null,"per:"]
[]
[]
[null,null,null,"c) Angaben zur FAHRT",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"d) Angaben zum ORGANISATOR",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Prüfung"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"^^"]
[null,null,null,"Fahrtziel",null,null,null,null,null,null,null,null,null,null,null,null,null,"*",null,"Fahrtorganisator(in)",null,null,null,null,null,null,null,"*",null,"ist Kl.leiter(in)",null,null,null,"*",null,"a"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"ja",null,null,"nein",null,null,"b"]
[]
[null,null,null,"Zeitraum der Fahrt",null,null,null,null,null,null,null,null,null,null,null,null,null,"*",null,"Datum, bis zu dem an den Organisator zu zahlen ist",null,null,null,null,null,null,null,null,null,null,null,null,null,"*",null,"c"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"d"]
[]
[null,null,null,"Kosten d. Fahrt gemäß Angabe der Schule / Organistor",null,null,null,null,null,null,null,null,null,null,null,null,null,"*",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"e"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"EUR",null,null,null,null,null,null," HAG-Fahrtinformation liegt bei.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"f"]
[]
["Formular Zuschussantrag Schülerfahrt V.5.0 - Stand 08.2017 - downloadbar: www.fk-hagh.net",null,null,"e) Angaben zum ZUSCHUSSBEDARF",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Genehmigung"]
[]
[null,null,null,"Zuschussbedarf",null,null,null,null,"*",null,"Anzahl",null,"*",null,"weitere Kinder leben in meinem Haushalt.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"wer:   VST / Beschl / @"]
[null,null,null,null,null,null,null,"EUR"]
[]
[null,null,null,null," Eine Bezuschussung wurde an anderer Stelle bereits beantragt.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"wieviel:"]
[null,null,null,"Eine andere Stelle hat eine Bezuschussung",null,null,null,null,null,null,null,null,null,null,null,null,null," abgelehnt",null,null,null,null," noch nicht entschieden",null,null,null,null,null,null,null,null,null,null,null,null,"wann:"]
[]
[null,null,null,"welche andere Stelle (Institution)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," Schreiben/Bescheid liegt bei"]
[]
[]
[null,null,null,"Nachweise/Glaubhaftmachung der Bedürftigkeit (Anträge / Schreiben / eigene Angaben / Zeugen / Bescheide / od. ähnl.)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"*",null,null,"Bearbeitung"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Korrekturen / Rückfr. / Überweisung"]
[]
[null,null,null,"ggf. auch gesond. Beiblatt beifügen",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"#"]
[]
[]
[null,null,null,"sonstige Bemerkungen / Erläuterungen",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"#"]
[]
[]
[null,null,null,"f) Kontoverbindung des ORGANISATORS, auf die der Zuschuss zu zahlen ist:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Rückmeldung"]
[]
[null,null,null,"Kontoinhaber (Vor+ Zuname) / des Fahrtorganisators",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"*",null,"Bescheid / @ / Tel / Mitteilung"]
[]
[]
[null,null,null,"IBAN",null,null,null,null,null,null,null,null,null,null,null,null,"*",null,"BIC",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"*"]
[]
[]
[null,null,null,"Bank- /Kreditinstitut",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"*",null,null,"Bemerkung"]
[]
[]
[null,null,null,"Ort, Datum",null,null,null,null,null,null,null,null,null,null,null,null,"*",null,"Unterschrift (Antragsteller)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"*"]
[]
[]
[]
[null,null,null,"Freundeskreis Hannah-Arendt-Gymnasium Haßloch e.V.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Bankverbindung",null,null,null,null,null,null,null,"Amtsgericht Ludwigshafen",null,null,null,null,null,null,null,null,"Norbert Moßbacher (Vorsitzender)"]
[null,null,null,"Viroflayer Straße 20",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"IBAN:  DE89546512400001012558",null,null,null,null,null,null,null,"Vereinsregister",null,null,null,null,null,null,null,null,"Im Mühlpfad 1 c"]
[null,null,null,"67454 Haßloch",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"BIC:     MALADE51DKH",null,null,null,null,null,null,null,"Registerblatt VR 41151",null,null,null,null,null,null,null,null,"67454 Haßloch"]
[null,null,null,"info@fk-hagh.net ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Sparkasse Rhein-Haardt",null,null,null,null,null,null,null,"gegründet 21.11.1990",null,null,null,null,null,null,null,null,"norbert.mossbacher@fk-hagh.net "]