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<title><!--{$arrSiteInfo.shop_name}-->/<!--{$tpl_title|escape}--></title>
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<body bgcolor="#ffe9e6" text="#555555" link="#3a75af" vlink="#3a75af" alink="#3a75af" leftmargin="0" topmargin="0" marginwidth="0" marginheight="0" onLoad="preLoadImg(); <!--{$tpl_onload}-->">
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<!--▼CONTENTS-->
<table width="550" border="0" cellspacing="0" cellpadding="0" summary=" ">
	<tr><td height="15"></td></tr>
	<tr><td bgcolor="#ffa85c"><img src="/misc/_.gif" width="1" height="5" alt=""></td></tr>
	<tr>
		<td align="center" bgcolor="#ffffff">

		<!--▼入力フォームここから-->
		<table width="500" border="0" cellspacing="0" cellpadding="0" summary=" ">
		<form name="form1" id="form1" method="post" action="<!--{$smarty.server.PHP_SELF}-->">
		<input type="hidden" name="mode" value="edit">
		<input type="hidden" name="other_deliv_id" value="<!--{$smarty.session.other_deliv_id}-->" >
		<input type="hidden" name="ParentPage" value="<!--{$ParentPage}-->" >

			<tr><td height="15"></td></tr>
			<tr>
				<td><img src="/img/shopping/delivadd_title.jpg" width="500" height="40" alt="新しいお届け先の追加・変更"></td>
			</tr>
			<tr><td height="15"></td></tr>
			<tr>
				<td class="fs12">下記項目にご入力ください。「<span class="red">※</span>」印は入力必須項目です。<br>
				入力後、一番下の「確認ページへ」ボタンをクリックしてください。</td>
			</tr>
			<tr><td height="15"></td></tr>
			<tr>
				<td bgcolor="#cccccc">
				<!--入力フォームここから-->
				<table width="500" border="0" cellspacing="1" cellpadding="10" summary=" ">
					<tr>
						<td width="117" bgcolor="#f0f0f0" class="fs12">お名前<span class="red">※</span></td>
						<td width="340" bgcolor="#ffffff" class="fs12n">
							<span class="red"><!--{$arrErr.name01}--><!--{$arrErr.name02}--></span>
							姓&nbsp;<input type="text" name="name01" value="<!--{if $name01 == ""}--><!--{$arrOtherDeliv.name01|escape}--><!--{else}--><!--{$name01|escape}--><!--{/if}-->" maxlength="<!--{$smarty.const.STEXT_LEN}-->" style="<!--{$arrErr.name01|sfGetErrorColor}-->" size=15 class="box15" />　
							名&nbsp;<input type="text" name="name02" value="<!--{if $name02 == ""}--><!--{$arrOtherDeliv.name02|escape}--><!--{else}--><!--{$name02|escape}--><!--{/if}-->" maxlength="<!--{$smarty.const.STEXT_LEN}-->" style="<!--{$arrErr.name02|sfGetErrorColor}-->" size=15 class="box15" />
						</td>
					</tr>
					<tr>
						<td bgcolor="#f0f0f0" class="fs12">お名前（フリガナ）<span class="red">※</span></td>
						<td bgcolor="#ffffff" class="fs12n"><span class="red"><!--{$arrErr.kana01}--><!--{$arrErr.kana02}--></span>
							セイ&nbsp;<input type="text" name="kana01" value="<!--{if $kana01 == ""}--><!--{$arrOtherDeliv.kana01|escape}--><!--{else}--><!--{$kana01|escape}--><!--{/if}-->" maxlength="<!--{$smarty.const.STEXT_LEN}-->" style="<!--{$arrErr.kana01|sfGetErrorColor}-->" size=15 class="box15" />　メイ&nbsp;<input type="text" name="kana02" value="<!--{if $kana02 == ""}--><!--{$arrOtherDeliv.kana02|escape}--><!--{else}--><!--{$kana02|escape}--><!--{/if}-->" maxlength="<!--{$smarty.const.STEXT_LEN}-->" style="<!--{$arrErr.kana02|sfGetErrorColor}-->" size=15 class="box15" /></td>
					</tr>
					<tr>
						<td bgcolor="#f0f0f0" class="fs12">郵便番号<span class="red">※</span></td>
						<td bgcolor="#ffffff">
							<table cellspacing="0" cellpadding="0" summary=" ">
								<tr>
									<td class="fs12n">
										<!--{assign var=key1 value="zip01"}-->
										<!--{assign var=key2 value="zip02"}-->
										<span class="red"><!--{$arrErr[$key1]}--><!--{$arrErr[$key2]}--></span>
										〒&nbsp;<input type="text" name="zip01" value="<!--{if $zip01 == ""}--><!--{$arrOtherDeliv.zip01|escape}--><!--{else}--><!--{$zip01|escape}--><!--{/if}-->" maxlength="<!--{$smarty.const.ZIP01_LEN}-->" style="<!--{$arrErr[$key1]|sfGetErrorColor}-->; ime-mode: disabled;" size=6 class="box6" />&nbsp;-&nbsp;<input type="text" name="zip02" value="<!--{if $zip02 == ""}--><!--{$arrOtherDeliv.zip02|escape}--><!--{else}--><!--{$zip02|escape}--><!--{/if}-->" maxlength="<!--{$smarty.const.ZIP02_LEN}-->" style="<!--{$arrErr[$key2]|sfGetErrorColor}-->; ime-mode: disabled;" size=6 class="box6" />
									</td>
									<td>
										&nbsp;&nbsp;<a href="../address/index.php" onclick="fnCallAddress('<!--{$smarty.const.URL_INPUT_ZIP}-->', 'zip01', 'zip02', 'pref', 'addr01'); return false;" target="_blank"><img src="../img/common/address.gif" width="86" height="20" alt="住所自動入力" /></a></td>
									</td>
								</tr>
								<tr><td height="5"></td></tr>
								<tr>
									<td colspan="2" class="fs12">郵便番号がわからない方は→<a href="http://search.post.japanpost.jp/7zip/" target="_blank">こちら</a></td>
								</tr>
							</table>
						</td>
					</tr>
					<tr>
						<td bgcolor="#f0f0f0" class="fs12">住所<span class="red">※</span></td>
						<td bgcolor="#ffffff">
							<table cellspacing="0" cellpadding="0" summary=" " id="frame02">
								<tr>
									<td class="fs12n"><span class="red"><!--{$arrErr.pref}--></span>
									<select name="pref" style="<!--{$arrErr.pref|sfGetErrorColor}-->">
									<option value="" selected>選択してください</option>
									<!--{if $pref == ""}-->
									<!--{html_options options=$arrPref selected=$arrOtherDeliv.pref|escape}-->
									<!--{else}-->
									<!--{html_options options=$arrPref selected=$pref|escape}-->
									<!--{/if}-->
									</select></td>
								</tr>
								<tr><td height="5"></td></tr>
								<tr>
									<td class="fs12n"><span class="red"><!--{$arrErr.addr01}--></span>
									<input type="text" name="addr01" value="<!--{if $addr01 == ""}--><!--{$arrOtherDeliv.addr01|escape}--><!--{else}--><!--{$addr01|escape}--><!--{/if}-->" maxlength="<!--{$smarty.const.MTEXT_LEN}-->" style="<!--{$arrErr.addr01|sfGetErrorColor}-->" size=40 class="box40" /></td>
								</tr>
								<tr><td height="2"></td></tr>
								<tr>
									<td class="fs10n">ご住所1（神戸市中央区）</td>
								</tr>
								<tr><td height="5"></td></tr>
								<tr>
									<td class="fs12n"><span class="red"><!--{$arrErr.addr02}--></span>
									<input type="text" name="addr02" value="<!--{if $addr02 == ""}--><!--{$arrOtherDeliv.addr02|escape}--><!--{else}--><!--{$addr02|escape}--><!--{/if}-->" maxlength="<!--{$smarty.const.MTEXT_LEN}-->" style="<!--{$arrErr.addr02|sfGetErrorColor}-->" size=40 class="box40" /></td>
								</tr>
								<tr><td height="2"></td></tr>
								<tr>
									<td class="fs10"><span class="red">住所は必ず2つに分けてご記入ください。マンション名は必ず記入してください。</span></td>
								</tr>
							</table>
						</td>
					</tr>
					<tr>
						<td bgcolor="#f0f0f0" class="fs12n">電話番号<span class="red">※</span></td>
						<td bgcolor="#ffffff" class="fs12n"><span class="red"><!--{$arrErr.tel01}--><!--{$arrErr.tel02}--><!--{$arrErr.tel03}--></span>
							<input type="text" name="tel01" value="<!--{if $tel01 == ""}--><!--{$arrOtherDeliv.tel01|escape}--><!--{else}--><!--{$tel01|escape}--><!--{/if}-->" maxlength="<!--{$smarty.const.TEL_ITEM_LEN}-->" style="<!--{$arrErr.tel01|sfGetErrorColor}-->" size=6 class="box6" />&nbsp;-&nbsp;<input type="text" name="tel02" value="<!--{if $tel02 == ""}--><!--{$arrOtherDeliv.tel02|escape}--><!--{else}--><!--{$tel02|escape}--><!--{/if}-->" maxlength="<!--{$smarty.const.TEL_ITEM_LEN}-->" style="<!--{$arrErr.tel02|sfGetErrorColor}-->" size=6 class="box6" />&nbsp;-&nbsp;<input type="text" name="tel03" value="<!--{if $tel03 == ""}--><!--{$arrOtherDeliv.tel03|escape}--><!--{else}--><!--{$tel03|escape}--><!--{/if}-->" maxlength="<!--{$smarty.const.TEL_ITEM_LEN}-->" style="<!--{$arrErr.tel03|sfGetErrorColor}-->" size=6 class="box6" /></td>
					</tr>
				</table>
				<!--入力フォームここまで-->
				</td>
			</tr>
			<tr><td height="15"></td></tr>
			<tr>
				<td align="center">
					<input type="image" onmouseover="chgImgImageSubmit('/img/common/b_entry_on.gif',this);" onmouseout="chgImgImageSubmit('/img/common/b_entry.gif',this);" src="/img/common/b_entry.gif" width="150" height="30" alt="登録する" name="register" id="register" />
				</td>
			</tr>
			<tr><td height="30"></td></tr>
		</form>
		</table>
		</td>
	</tr>
	<tr><td bgcolor="#ffa85c"><img src="/misc/_.gif" width="1" height="5" alt=""></td></tr>
	<tr><td height="20"></td></tr>
</table>
</div>
</body>
</html>



