ｳ�ｰｲ�ﾒﾀ鯱ﾕ･ｭ･罕遙｡､ｪﾌ荵遉ｻ･ﾕ･ｩ｡ｼ･漱/title> </head> <body> <div id = "formmailmagic"> <h1 class = "title">ｳ�ｰｲ�ﾒﾀ鯱ﾕ･ｭ･罕遙｡､ｪﾌ荵遉ｻ･ﾕ･ｩ｡ｼ･漱/h1> <h2 class = "setumei">ﾀ鯱ﾕ･ｭ･罕熙ﾘ､ﾎ､ｪﾌ荵遉ｻ､ﾏｲｼｵｭｹ猯ﾜ､�ｴﾆ�ﾎﾏ､ﾎｾ蝪｢ﾁ�ｮ､ｯ､ﾀ､ｵ､､｡｣</h2> <form method="POST" action="/form/index.php"> <table summary="､ｪﾌ荀､ｹ遉�ｻ､ﾋｴﾘ､ｹ､��ﾎﾏｹ猯ﾜﾌｾ､ﾈ､ｽ､ﾎﾆ�ﾎﾏﾍ� cellspacing="0"> <tr> <th scope = "row" class = "must">､ｪﾌｾﾁｰ<em class = "must">｢ｨﾉｬｿﾜ</em><br><em class = "check">(ﾁｴｳﾑﾊｸｻ�</em></th> <td> ｡ﾊﾀｫ｡ﾋ｡ｧ<input type = "text" name = "name_seimei[]" value = "" size = "10" maxlength = "10" > ｡ﾊﾌｾ｡ﾋ｡ｧ<input type = "text" name = "name_seimei[]" value = "" size = "10" maxlength = "10" > </td> </tr> <tr> <th scope = "row" >､ﾕ､熙ｬ､ﾊ</th> <td> ｡ﾊﾀｫ｡ﾋ｡ｧ<input type = "text" name = "hurigana3[]" value = "" size = "10" maxlength = "10" > ｡ﾊﾌｾ｡ﾋ｡ｧ<input type = "text" name = "hurigana3[]" value = "" size = "10" maxlength = "10" > </td> </tr> <tr> <th scope = "row" class = "must">･癸ｼ･�｢･ﾉ･�ｹ<em class = "must">｢ｨﾉｬｿﾜ</em></th> <td> <input type = "text" name = "mail_kakunin[]" value = "" size = "50" maxlength = "50" > <br>｢ｨｳﾎﾇｧ､ﾎ､ｿ､癸｢ｺﾆﾅﾙﾆ�ﾎﾏ､ｷ､ﾆ､ｯ､ﾀ､ｵ､､<br> <input type = "text" name = "mail_kakunin[]" value = "" size = "50" maxlength = "50" > </td> </tr> <tr> <th scope = "row" >ﾍｹﾊﾘﾈﾖｹ襌/th> <td> <input type = "text" name = "yuubinbangou[]" value = "" size = "3" maxlength = "3" > ｡ﾝ<input type = "text" name = "yuubinbangou[]" value = "" size = "4" maxlength = "4" > </td> </tr> <tr> <th scope = "row" >ﾅﾔﾆｻﾉﾜｸｩ</th> <td> <select name = "todouhuken"> <option value = "" selected></option> <option value = "ﾀ鯱ﾕｸｩ" >ﾀ鯱ﾕｸｩ</option> <option value = "ﾋﾌｳ､ﾆｻ" >ﾋﾌｳ､ﾆｻ</option> <option value = "ﾀﾄｿｹｸｩ" >ﾀﾄｿｹｸｩ</option> <option value = "ｴ莨�ｩ" >ｴ莨�ｩ</option> <option value = "ｵﾜｾ�ｩ" >ｵﾜｾ�ｩ</option> <option value = "ｽｩﾅﾄｸｩ" >ｽｩﾅﾄｸｩ</option> <option value = "ｻｳｷﾁｸｩ" >ｻｳｷﾁｸｩ</option> <option value = "ﾊ｡ﾅ邵ｩ" >ﾊ｡ﾅ邵ｩ</option> <option value = "ｿｷｳ羣ｩ" >ｿｷｳ羣ｩ</option> <option value = "ﾉﾙｻｳｸｩ" >ﾉﾙｻｳｸｩ</option> <option value = "ﾀﾐﾀ�ｩ" >ﾀﾐﾀ�ｩ</option> <option value = "ﾊ｡ｰ貂ｩ" >ﾊ｡ｰ貂ｩ</option> <option value = "ﾅ��ﾅﾔ" >ﾅ��ﾅﾔ</option> <option value = "ｿﾀﾆ狢�ｩ" >ｿﾀﾆ狢�ｩ</option> <option value = "ｰ��ｩ" >ｰ��ｩ</option> <option value = "ﾆﾊﾌﾚｸｩ" >ﾆﾊﾌﾚｸｩ</option> <option value = "ｷｲﾇﾏｸｩ" >ｷｲﾇﾏｸｩ</option> <option value = "ｺ�ﾌｸｩ" >ｺ�ﾌｸｩ</option> <option value = "ｻｳﾍ�ｩ" >ｻｳﾍ�ｩ</option> <option value = "ﾄｹﾌ�ｩ" >ﾄｹﾌ�ｩ</option> <option value = "ｴ��ｩ" >ｴ��ｩ</option> <option value = "ﾀﾅｲｬｸｩ" >ﾀﾅｲｬｸｩ</option> <option value = "ｰｦﾃﾎｸｩ" >ｰｦﾃﾎｸｩ</option> <option value = "ｻｰｽﾅｸｩ" >ｻｰｽﾅｸｩ</option> <option value = "ｼ｢ｲ�ｩ" >ｼ｢ｲ�ｩ</option> <option value = "ﾏﾂｲﾎｻｳｸｩ" >ﾏﾂｲﾎｻｳｸｩ</option> <option value = "ｵ�ﾅﾔﾉﾜ" >ｵ�ﾅﾔﾉﾜ</option> <option value = "ﾂ郤衙ﾜ" >ﾂ郤衙ﾜ</option> <option value = "ﾊｼｸﾋｸｩ" >ﾊｼｸﾋｸｩ</option> <option value = "ﾆ猥ﾉｸｩ" >ﾆ猥ﾉｸｩ</option> <option value = "ﾅ郤ｬｸｩ" >ﾅ郤ｬｸｩ</option> <option value = "ﾄｻｼ雕ｩ" >ﾄｻｼ雕ｩ</option> <option value = "ｲｬｻｳｸｩ" >ｲｬｻｳｸｩ</option> <option value = "ｹｭﾅ邵ｩ" >ｹｭﾅ邵ｩ</option> <option value = "ｻｳｸ�ｸｩ" >ｻｳｸ�ｸｩ</option> <option value = "ﾆﾁﾅ邵ｩ" >ﾆﾁﾅ邵ｩ</option> <option value = "ｹ眤�ｩ" >ｹ眤�ｩ</option> <option value = "ｰｦﾉｲｸｩ" >ｰｦﾉｲｸｩ</option> <option value = "ｹ篥ﾎｸｩ" >ｹ篥ﾎｸｩ</option> <option value = "ﾊ｡ｲｬｸｩ" >ﾊ｡ｲｬｸｩ</option> <option value = "ｺｴｲ�ｩ" >ｺｴｲ�ｩ</option> <option value = "ﾄｹｺ�ｩ" >ﾄｹｺ�ｩ</option> <option value = "ｷｧﾋﾜｸｩ" >ｷｧﾋﾜｸｩ</option> <option value = "ﾂ醋ｬｸｩ" >ﾂ醋ｬｸｩ</option> <option value = "ｵﾜｺ�ｩ" >ｵﾜｺ�ｩ</option> <option value = "ｼｯｻ�邵ｩ" >ｼｯｻ�邵ｩ</option> <option value = "ｲｭﾆ�ｩ" >ｲｭﾆ�ｩ</option> </select> </td> </tr> <tr> <th scope = "row" >ｻﾔｶ霪ｮﾂｼ｡ｦﾈﾖﾃﾏ</th> <td> <input type = "text" name = "sikutyouson" value = "" size = "40" maxlength = "40" > </td> </tr> <tr> <th scope = "row" class = "must">ﾅﾅﾏﾃﾈﾖｹ襌em class = "must">｢ｨﾉｬｿﾜ</em><br><em class = "check">(ﾈｾｳﾑｿ��</em></th> <td> <input type = "text" name = "tel[]" value = "" size = "5" maxlength = "5" > ｡ﾝ<input type = "text" name = "tel[]" value = "" size = "5" maxlength = "5" > ｡ﾝ<input type = "text" name = "tel[]" value = "" size = "5" maxlength = "5" > </td> </tr> <tr> <th scope = "row" >ｵｮｼﾒﾌｾ(ﾋ｡ｿﾍ､ﾎ､ｪﾌ荵遉ｻ､ﾎｾ��</th> <td> <input type = "text" name = "houjinmei" value = "" size = "40" maxlength = "40" > </td> </tr> <tr> <th scope = "row" >ﾉ��/th> <td> <input type = "text" name = "busyo" value = "" size = "40" maxlength = "40" > </td> </tr> <tr> <th scope = "row" >ﾌ�ｦ</th> <td> <input type = "text" name = "sonota" value = "" size = "40" maxlength = "40" > </td> </tr> <tr> <th scope = "row" class = "must">､ｪﾌ荀､ｹ遉�ｻｼ�ﾌ<em class = "must">｢ｨﾉｬｿﾜ</em></th> <td> <select name = "syubetu"> <option value = "｡ﾚTLC｡ﾛｺﾎﾍﾑｻﾙｱ遉ﾋ､ﾄ､､､ﾆ､ﾎ､ｪﾌ荵遉ｻ" >｡ﾚTLC｡ﾛｺﾎﾍﾑｻﾙｱ遉ﾋ､ﾄ､､､ﾆ､ﾎ､ｪﾌ荵遉ｻ</option> <option value = "｡ﾚTLC｡ﾛTLC､ﾇﾆｯ､ｭ､ｿ､､｡ｪ､ｽ､ﾎﾁｰ､ﾋ､ｪﾌ荵遉ｻ" >｡ﾚTLC｡ﾛTLC､ﾇﾆｯ､ｭ､ｿ､､｡ｪ､ｽ､ﾎﾁｰ､ﾋ､ｪﾌ荵遉ｻ</option> <option value = "｡ﾚTLC｡ﾛﾁ�ﾟ･��ｯ､ﾎ､ｪﾌ荵遉ｻ" >｡ﾚTLC｡ﾛﾁ�ﾟ･��ｯ､ﾎ､ｪﾌ荵遉ｻ</option> <option value = "｡ﾚTLC｡ﾛｶ��ﾎ､ｴﾏ｢ﾍ� >｡ﾚTLC｡ﾛｶ��ﾎ､ｴﾏ｢ﾍ�/option> <option value = "｡ﾚTLC｡ﾛﾊﾀｼﾒ､ﾘ､ﾎ､ｴﾄ�ﾆ" >｡ﾚTLC｡ﾛﾊﾀｼﾒ､ﾘ､ﾎ､ｴﾄ�ﾆ</option> <option value = "｡ﾚTLC｡ﾛ､ｽ､ﾎﾂｾ､ﾎ､ｪﾌ荵遉ｻ" >｡ﾚTLC｡ﾛ､ｽ､ﾎﾂｾ､ﾎ､ｪﾌ荵遉ｻ</option> </select> </td> </tr> <tr> <th scope = "row" class = "must">､ｪﾌ荀､ｹ遉�ｻﾆ簣ﾆ<em class = "must">｢ｨﾉｬｿﾜ</em></th> <td> <textarea name = "naiyou" cols = "40" rows = "10" wrap="soft"></textarea> </td> </tr> </table> <div class = "send_kakunin"><input type = "checkbox" name = "g_send_kakunin_mail" value = "ｳﾎﾇｧ､ﾎ･癸ｼ･��ｮ､ｹ､� checked>ｳﾎﾇｧ､ﾎ･癸ｼ･��ｮ､ｹ､�/div> <div class = "confirm"><input type="button" name="reset" value="･�ｻ･ﾃ･ﾈ" onClick="location.href='/form/index.php'"> <input type="submit" name="confirm" value="ｳﾎﾇｧ､ｹ､�></div> </form> <p class = "copyright"><a class = "copyright" href = "http://sato-web.net">FormMail Magic V1.1</a></p> </div> </body> </html>