| 1 | <!--{* |
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| 2 | /* |
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| 3 | * This file is part of EC-CUBE |
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| 4 | * |
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| 5 | * Copyright(c) 2000-2010 LOCKON CO.,LTD. All Rights Reserved. |
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| 6 | * |
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| 7 | * http://www.lockon.co.jp/ |
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| 8 | * |
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| 9 | * This program is free software; you can redistribute it and/or |
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| 10 | * modify it under the terms of the GNU General Public License |
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| 11 | * as published by the Free Software Foundation; either version 2 |
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| 12 | * of the License, or (at your option) any later version. |
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| 13 | * |
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| 14 | * This program is distributed in the hope that it will be useful, |
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| 15 | * but WITHOUT ANY WARRANTY; without even the implied warranty of |
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| 16 | * MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE. See the |
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| 17 | * GNU General Public License for more details. |
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| 18 | * |
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| 19 | * You should have received a copy of the GNU General Public License |
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| 20 | * along with this program; if not, write to the Free Software |
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| 21 | * Foundation, Inc., 59 Temple Place - Suite 330, Boston, MA 02111-1307, USA. |
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| 22 | */ |
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| 23 | *}--> |
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| 24 | <form name="form1" id="form1" method="post" action="?" utn> |
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| 25 | <input type="hidden" name="mode" value="complete"> |
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| 26 | <input type="hidden" name="<!--{$smarty.const.TRANSACTION_ID_NAME}-->" value="<!--{$transactionid}-->" /> |
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| 27 | <!--{foreach from=$list_data key=key item=item}--> |
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| 28 | <input type="hidden" name="<!--{$key|h}-->" value="<!--{$item|h}-->"> |
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| 29 | <!--{/foreach}--> |
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| 30 | 下記の内容でご登録してもよろしいですか？<br> |
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| 31 | <br> |
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| 32 | ●ﾒｰﾙｱﾄﾞﾚｽ<br> |
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| 33 | <!--{$list_data.email|h}--><br> |
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| 34 | |
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| 35 | ●ﾊﾟｽﾜｰﾄﾞ確認用質問<br> |
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| 36 | <!--{$arrReminder[$list_data.reminder]|h}--><br> |
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| 37 | |
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| 38 | ●質問の答え<br> |
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| 39 | <!--{$list_data.reminder_answer|h}--><br> |
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| 40 | |
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| 41 | ●お名前<br> |
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| 42 | <!--{$list_data.name01|h}--> <!--{$list_data.name02|h}--><br> |
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| 43 | |
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| 44 | ●お名前(フリガナ)<br> |
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| 45 | <!--{$list_data.kana01|h}--> <!--{$list_data.kana02|h}--><br> |
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| 46 | |
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| 47 | ●性別<br> |
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| 48 | <!--{if $list_data.sex eq 1}-->男性<!--{else}-->女性<!--{/if}--><br> |
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| 49 | |
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| 50 | ●生年月日<br> |
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| 51 | <!--{if strlen($list_data.year) > 0 && strlen($list_data.month) > 0 && strlen($list_data.day) > 0}--><!--{$list_data.year|h}-->年<!--{$list_data.month|h}-->月<!--{$list_data.day|h}-->日生まれ<!--{else}-->未登録<!--{/if}--><br> |
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| 52 | |
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| 53 | ●住所<br> |
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| 54 | 〒<!--{$list_data.zip01|h}--> - <!--{$list_data.zip02|h}--><br> |
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| 55 | <!--{$arrPref[$list_data.pref]|h}--><!--{$list_data.addr01|h}--><!--{$list_data.addr02|h}--><br> |
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| 56 | |
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| 57 | ●電話番号<br> |
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| 58 | <!--{$list_data.tel01|h}-->-<!--{$list_data.tel02|h}-->-<!--{$list_data.tel03|h}--><br> |
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| 59 | |
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| 60 | ●ﾒｰﾙﾏｶﾞｼﾞﾝﾞ<br> |
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| 61 | <!--{if $list_data.mailmaga_flg eq 2}-->希望する<!--{else}-->希望しない<!--{/if}--><br> |
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| 62 | <br> |
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| 63 | |
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| 64 | <input type="submit" name="submit" value="登録"><br> |
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| 65 | <input type="submit" name="return" value="戻る"> |
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| 66 | </form> |
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