1 | <!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN"> |
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2 | <html lang="ja"> |
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3 | <!--{* |
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4 | * This file is part of EC-CUBE |
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5 | * |
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6 | * Copyright(c) 2000-2007 LOCKON CO.,LTD. All Rights Reserved. |
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7 | * |
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8 | * http://www.lockon.co.jp/ |
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9 | * |
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10 | * This program is free software; you can redistribute it and/or |
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11 | * modify it under the terms of the GNU General Public License |
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12 | * as published by the Free Software Foundation; either version 2 |
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13 | * of the License, or (at your option) any later version. |
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14 | * |
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15 | * This program is distributed in the hope that it will be useful, |
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16 | * but WITHOUT ANY WARRANTY; without even the implied warranty of |
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17 | * MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE. See the |
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18 | * GNU General Public License for more details. |
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19 | * |
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20 | * You should have received a copy of the GNU General Public License |
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21 | * along with this program; if not, write to the Free Software |
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22 | * Foundation, Inc., 59 Temple Place - Suite 330, Boston, MA 02111-1307, USA. |
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23 | }--> |
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24 | <head> |
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25 | <link rel="stylesheet" href="<!--{$smarty.const.URL_DIR}-->css/contents.css" type="text/css"> |
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26 | <link rel="stylesheet" href="<!--{$smarty.const.URL_DIR}-->css/common.css" type="text/css"> |
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27 | <script type="text/javascript" src="<!--{$smarty.const.URL_DIR}-->js/css.js"></script> |
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28 | <script type="text/javascript" src="<!--{$smarty.const.URL_DIR}-->js/navi.js"></script> |
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29 | <script type="text/javascript" src="<!--{$smarty.const.URL_DIR}-->js/site.js"></script> |
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30 | <script type="text/javascript" src="<!--{$smarty.const.URL_DIR}-->js/win_op.js"></script> |
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31 | <title><!--{$arrSiteInfo.shop_name}-->/アンケート <!--{$QUESTION.title|escape}--></title> |
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32 | </head> |
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33 | <body bgcolor="#ffffff" text="#555555" link="#0099cc" vlink="#CC0000" alink="#993399" leftmargin="0" topmargin="0" marginwidth="0" marginheight="0"> |
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34 | |
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35 | |
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36 | <!--▲TITLE--> |
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37 | <table width="760" border="0" cellspacing="0" cellpadding="0" summary=" "> |
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38 | <tr> |
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39 | <td height="40" bgcolor="#f6f6f6" align="center"> |
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40 | <table width="710" border="0" cellspacing="0" cellpadding="0" summary=" "> |
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41 | <tr> |
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42 | <td height="30" bgcolor="ff0000"><img src="../misc/_.gif" width="7" height="1" alt=""></td> |
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43 | <td height="30"><img src="../misc/_.gif" width="8" height="1" alt=""></td> |
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44 | <td height="30"width="695" class="red"><strong><span class="fs18n"><!--{$QUESTION.title|escape}--></span></strong></td> |
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45 | </tr> |
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46 | </table> |
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47 | </td> |
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48 | </tr> |
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49 | <tr> |
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50 | <td bgcolor="#e2e2e2"><img src="../misc/_.gif" width="10" height="1" alt=""></td> |
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51 | </tr> |
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52 | <tr><td height="10"></td></tr> |
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53 | <tr> |
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54 | <td align="center" valign="top"> |
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55 | <table width="600" border="0" cellspacing="0" cellpadding="0" summary=" "> |
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56 | <form name="form1" id="form1" method="post" action="<!--{$smarty.server.PHP_SELF|escape}-->"> |
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57 | <input type="hidden" name="question_id" value="<!--{$question_id}-->"> |
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58 | <tr> |
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59 | <td class="fs12"><!--{$QUESTION.contents|escape|nl2br}--> |
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60 | </td> |
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61 | </tr> |
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62 | <tr><td height="10"></td></tr> |
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63 | <!--{if $errmsg}--><tr><td class="fs12n"><span class="red"><br>入力エラーが発生致しました。各項目のエラーメッセージをご確認の上、正しく入力してください。</span></td></tr><!--{/if}--> |
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64 | <tr> |
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65 | <td bgcolor="#cccccc"> |
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66 | <table width="600" border="0" cellspacing="1" cellpadding="10" summary=" "> |
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67 | <!--{include file=inquiry/inquiry.tpl}--> |
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68 | </table> |
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69 | </td> |
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70 | </tr> |
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71 | <tr><td height="30"></td></tr> |
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72 | <tr> |
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73 | <td class="fs12n"><span class="red">※</span>印は入力必須項目です。</td> |
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74 | </tr> |
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75 | <tr><td height="5"></td></tr> |
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76 | <input type="hidden" name="mode" value="confirm"> |
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77 | <tr> |
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78 | <td bgcolor="#cccccc"> |
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79 | <table width="600" border="0" cellspacing="1" cellpadding="10"> |
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80 | |
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81 | <tr> |
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82 | <td class="fs12n" bgcolor="#ebf9ff" width="150"><span class="red">※</span>お名前</td> |
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83 | <td class="fs12n"bgcolor="#ffffff" width="407"> |
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84 | <span class="red"><!--{$arrErr.name01}--><!--{$arrErr.name02}--></span> |
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85 | <input type="text" name="name01" value="<!--{$arrForm.name01|escape}-->" maxlength="<!--{$smarty.const.STEXT_LEN}-->" size="20" class="box20" <!--{if $arrErr.name01}--><!--{sfSetErrorStyle}--><!--{/if}--> /> |
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86 | <input type="text" name="name02" value="<!--{$arrForm.name02|escape}-->" maxlength="<!--{$smarty.const.STEXT_LEN}-->" size="20" class="box20" <!--{if $arrErr.name02}--><!--{sfSetErrorStyle}--><!--{/if}--> /> |
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87 | </td> |
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88 | </tr> |
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89 | <tr> |
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90 | <td class="fs12n" bgcolor="#ebf9ff" width="150"><span class="red">※</span>フリガナ</td> |
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91 | <td class="fs12n" bgcolor="#ffffff" width="407"> |
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92 | <span class="red"><!--{$arrErr.kana01}--><!--{$arrErr.kana02}--></span> |
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93 | <input type="text" name="kana01" value="<!--{$arrForm.kana01|escape}-->" maxlength="<!--{$smarty.const.STEXT_LEN}-->" size="20" class="box20" <!--{if $arrErr.kana01}--><!--{sfSetErrorStyle}--><!--{/if}--> /> |
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94 | <input type="text" name="kana02" value="<!--{$arrForm.kana02|escape}-->" maxlength="<!--{$smarty.const.STEXT_LEN}-->" size="20" class="box20" <!--{if $arrErr.kana02}--><!--{sfSetErrorStyle}--><!--{/if}--> /> |
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95 | </td> |
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96 | </tr> |
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97 | <tr> |
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98 | <td class="fs12n" bgcolor="#ebf9ff" width="150"><span class="red">※</span>郵便番号</td> |
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99 | <td bgcolor="#ffffff" width="407"> |
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100 | <table width="407" border="0" cellspacing="0" cellpadding="0" summary=" "> |
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101 | <tr> |
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102 | <td class="fs12n" width="267"> |
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103 | <span class="red"><!--{$arrErr.zip01}--><!--{$arrErr.zip02}--></span> |
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104 | 〒 <input type="text" name="zip01" value="<!--{$arrForm.zip01|escape}-->" maxlength="<!--{$smarty.const.ZIP01_LEN}-->" size="6" class="box6" maxlength="3" <!--{if $arrErr.zip01}--><!--{sfSetErrorStyle}--><!--{/if}--> /> |
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105 | - |
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106 | <input type="text" name="zip02" value="<!--{$arrForm.zip02|escape}-->" maxlength="<!--{$smarty.const.ZIP02_LEN}-->" size="6" class="box6" maxlength="4" <!--{if $arrErr.zip02}--><!--{sfSetErrorStyle}--><!--{/if}--> /> <input type="button" name="address_input" value="住所入力" onclick="fnCallAddress('<!--{$smarty.const.URL_INPUT_ZIP}-->', 'zip01', 'zip02', 'pref', 'addr01'); return false;" /> |
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107 | </td> |
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108 | </tr> |
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109 | </table> |
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110 | </td> |
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111 | </tr> |
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112 | <tr> |
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113 | <td class="fs12n" bgcolor="#ebf9ff" width="150"><span class="red">※</span>ご住所</td> |
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114 | <td bgcolor="#ffffff"> |
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115 | <table width="407" border="0" cellspacing="0" cellpadding="0" summary=" "> |
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116 | <tr> |
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117 | <td class="fs12n" colspan="2"> |
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118 | <span class="red"><!--{$arrErr.pref}--><!--{$arrErr.addr01}--><!--{$arrErr.addr02}--></span> |
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119 | <select name="pref" <!--{if $arrErr.pref}--><!--{sfSetErrorStyle}--><!--{/if}-->> |
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120 | <option value="" selected>選択してください</option> |
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121 | <!--{html_options options=$arrPref selected=$arrForm.pref}--> |
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122 | </select> |
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123 | </td> |
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124 | </tr> |
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125 | <tr><td height="5"></td></tr> |
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126 | <tr> |
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127 | <td width="207"> |
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128 | <input type="text" name="addr01" value="<!--{$arrForm.addr01|escape}-->" size="35" class="box35" <!--{if $arrErr.addr01}--><!--{sfSetErrorStyle}--><!--{/if}--> /> |
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129 | </td> |
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130 | <td width="200"><span class="fs10n">ご住所1(市区町村名)</span></td> |
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131 | </tr> |
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132 | <tr><td height="3"></td></tr> |
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133 | <tr> |
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134 | <td class="fs12n"> |
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135 | <input type="text" name="addr02" value="<!--{$arrForm.addr02|escape}-->" size="35" class="box35" <!--{if $arrErr.addr02}--><!--{sfSetErrorStyle}--><!--{/if}--> /> |
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136 | </td> |
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137 | <td><span class="fs10n">ご住所2(番地、建物、マンション名)</span><br></td> |
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138 | </tr> |
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139 | <tr> |
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140 | <td><span class="fs10n"><span class="red">住所は必ず2つに分けて入力してください。マンション名は必ず入力してください。</span></span></td> |
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141 | </tr> |
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142 | </table> |
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143 | </td> |
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144 | </tr> |
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145 | <tr> |
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146 | <td class="fs12n" bgcolor="#ebf9ff" width="150"><span class="red">※</span>お電話番号</td> |
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147 | <td class="fs12n" bgcolor="#ffffff" width="407"> |
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148 | <span class="red"><!--{$arrErr.tel01}--><!--{$arrErr.tel02}--><!--{$arrErr.tel03}--></span> |
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149 | <input type="text" name="tel01" value="<!--{$arrForm.tel01|escape}-->" maxlength="<!--{$smarty.const.TEL_ITEM_LEN}-->" size="6" class="box6" <!--{if $arrErr.tel01}--><!--{sfSetErrorStyle}--><!--{/if}--> /> - |
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150 | <input type="text" name="tel02" value="<!--{$arrForm.tel02|escape}-->" maxlength="<!--{$smarty.const.TEL_ITEM_LEN}-->" size="6" class="box6" <!--{if $arrErr.tel02}--><!--{sfSetErrorStyle}--><!--{/if}--> /> - |
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151 | <input type="text" name="tel03" value="<!--{$arrForm.tel03|escape}-->" maxlength="<!--{$smarty.const.TEL_ITEM_LEN}-->" size="6" class="box6" <!--{if $arrErr.tel03}--><!--{sfSetErrorStyle}--><!--{/if}--> /> |
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152 | </td> |
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153 | </tr> |
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154 | <tr> |
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155 | <td class="fs12n" bgcolor="#ebf9ff" width="150"><span class="red">※</span>メールアドレス</td> |
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156 | <td bgcolor="#ffffff"> |
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157 | <table width="407" border="0" cellspacing="0" cellpadding="0"> |
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158 | <tr> |
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159 | <td class="fs12n" colspan="2"> |
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160 | <span class="red"><!--{$arrErr.email}--></span> |
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161 | <input type="text" name="email" value="<!--{$arrForm.email|escape}-->" size="35" class="box35" <!--{if $arrErr.email}--><!--{sfSetErrorStyle}--><!--{/if}--> /> |
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162 | </td> |
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163 | </tr> |
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164 | <tr><td height="3"></td></tr> |
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165 | <tr> |
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166 | <td class="fs12n" width="227"> |
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167 | <span class="red"><!--{$arrErr.email02}--></span> |
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168 | <input type="text" name="email02" value="<!--{$arrForm.email02|escape}-->" size="35" class="box35" <!--{if $arrErr.email02}--><!--{sfSetErrorStyle}--><!--{/if}--> /> |
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169 | </td> |
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170 | <td width="180" class="fs10"><span class="red">確認のため2度入力してください。</span></td> |
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171 | </tr> |
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172 | </table> |
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173 | </td> |
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174 | </tr> |
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175 | </table> |
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176 | </td> |
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177 | </tr> |
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178 | <tr><td height="15"></td></tr> |
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179 | <tr> |
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180 | <td align="center"><input type="submit" name="subm1" value="確認ページへ"></td> |
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181 | </tr> |
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182 | </form> |
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183 | </table> |
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184 | <br> |
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185 | |
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186 | </td> |
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187 | </tr> |
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188 | </table> |
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189 | |
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190 | </body> |
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191 | </html> |
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