<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN">
<html lang="ja">
<!--{*
* This file is part of EC-CUBE
*
* Copyright(c) 2000-2007 LOCKON CO.,LTD. All Rights Reserved.
*
* http://www.lockon.co.jp/
*
* This program is free software; you can redistribute it and/or
* modify it under the terms of the GNU General Public License
* as published by the Free Software Foundation; either version 2
* of the License, or (at your option) any later version.
*
* This program is distributed in the hope that it will be useful,
* but WITHOUT ANY WARRANTY; without even the implied warranty of
* MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE. See the
* GNU General Public License for more details.
*
* You should have received a copy of the GNU General Public License
* along with this program; if not, write to the Free Software
* Foundation, Inc., 59 Temple Place - Suite 330, Boston, MA 02111-1307, USA.
*}-->
<head>
<link rel="stylesheet" href="<!--{$smarty.const.URL_DIR}--><!--{$smarty.const.USER_DIR}-->css/common.css" type="text/css">
<script type="text/javascript" src="<!--{$TPL_DIR}-->js/css.js"></script>
<script type="text/javascript" src="<!--{$TPL_DIR}-->js/navi.js"></script>
<script type="text/javascript" src="<!--{$TPL_DIR}-->js/site.js"></script>
<script type="text/javascript" src="<!--{$TPL_DIR}-->js/win_op.js"></script>
<title><!--{$arrSiteInfo.shop_name}-->/アンケート　<!--{$QUESTION.title|escape}-->/確èªç”»é¢</title>
<script type="text/javascript">
<!--
function func_return(){
document.form1.mode.value = "return";
document.form1.submit();
}
//-->
</script>
</head>
<body bgcolor="#ffffff" text="#555555" link="#0099cc" vlink="#CC0000" alink="#993399" leftmargin="0" topmargin="0" marginwidth="0" marginheight="0">
<!--â–²TITLE-->
<table width="760" border="0" cellspacing="0" cellpadding="0" summary=" ">
<tr>
<td height="40" bgcolor="#f6f6f6" align="center">
<table width="710" border="0" cellspacing="0" cellpadding="0" summary=" ">
<tr>
<td height="30" bgcolor="ff0000"><img src="../misc/_.gif" width="7" height="1" alt=""></td>
<td height="30"><img src="../misc/_.gif" width="8" height="1" alt=""></td>
<td height="30"width="695" class="red"><strong><span class="fs18n"><!--{$QUESTION.title|escape}--></span></strong></td>
</tr>
</table>
</td>
</tr>
<tr>
<td bgcolor="#e2e2e2"><img src="../misc/_.gif" width="10" height="1" alt=""></td>
</tr>
<tr><td height="10"></td></tr>
<tr>
<td align="center" valign="top">
<table width="600" border="0" cellspacing="0" cellpadding="0" summary=" ">
<tr>
<td class="fs12"><!--{$QUESTION.contents|nl2br}-->
</td>
</tr>
<tr><td height="10"></td></tr>
<!--{if $errmsg}--><tr><td class="fs12n"><span class="red"><br>入力エラーãŒç™ºç”Ÿè‡´ã—ã¾ã—ãŸã€‚å„é …ç›®ã®ã‚¨ãƒ©ãƒ¼ãƒ¡ãƒƒã‚»ãƒ¼ã‚¸ã‚’ã”確èªã®ä¸Šã€æ£ã—ã入力ã—ã¦ãã ã•ã„。</span></td></tr><!--{/if}-->
<tr>
<td bgcolor="#cccccc">
<table width="600" border="0" cellspacing="1" cellpadding="10" summary=" ">
<!--{section name=question loop=$QUESTION.question}-->
<!--{if $QUESTION.question[question].kind ne '0' }-->
<tr>
<td colspan="2" bgcolor="#edf6ff" class="fs12n">質å•<!--{$smarty.section.question.iteration}-->：<!--{$QUESTION.question[question].name|escape}--></td>
</tr>
<!--{if $QUESTION.question[question].kind eq 1}-->
<tr>
<td colspan="2" bgcolor="ffffff" class="fs12n">
<!--{$smarty.post.option[$smarty.section.question.index]|nl2br}-->
</td>
</tr>
<!--{elseif $QUESTION.question[question].kind eq 2}-->
<tr>
<td colspan="2" bgcolor="ffffff" class="fs12n">
<!--{$smarty.post.option[$smarty.section.question.index]|escape}-->
</td>
</tr>
<!--{elseif $QUESTION.question[question].kind eq 4}-->
<tr>
<td colspan="2" bgcolor="ffffff" class="fs12n">
<!--{lfArray_Search_key_Smarty arr=$QUESTION.question[question].option val=$smarty.post.option[$smarty.section.question.index] }-->
</td>
</tr>
<!--{elseif $QUESTION.question[question].kind eq 3}-->
<tr>
<td colspan="2" bgcolor="ffffff" class="fs12n">
<!--{foreach item=sub from=$smarty.post.option[question]}-->
<!--{if strlen($sub) > 0}-->
<!--{lfArray_Search_key_Smarty arr=$QUESTION.question[question].option val=$sub }--><br>
<!--{/if}-->
<!--{/foreach}-->
</td>
</tr>
<!--{/if}-->
<!--{/if}-->
<!--{/section}-->
</table>
</td>
</tr>
<tr><td height="30"></td></tr>
<tr>
<td class="fs12n"><span class="red">※</span>å°ã¯å…¥åŠ›å¿…é ˆé …ç›®ã§ã™ã€‚</td>
</tr>
<tr><td height="5"></td></tr>
<form name="form1" method="post" action="<!--{$smarty.server.PHP_SELF|escape}-->">
<input type="hidden" name="mode" value="regist">
<!--{foreach key=key item=item from=$arrHidden}-->
<input type="hidden" name="<!--{$key}-->" value="<!--{$item|escape}-->" >
<!--{/foreach}-->
<tr>
<td bgcolor="#cccccc">
<table width="600" border="0" cellspacing="1" cellpadding="10">
<tr>
<td class="fs12n" bgcolor="#ebf9ff" width="150"><span class="red">※</span>ãŠåå‰</td>
<td class="fs12"bgcolor="#ffffff" width="407" class="fs12n">
<!--{$arrForm.name01|escape}--> <!--{$arrForm.name02|escape}-->
<input type="hidden" name="name01" value="<!--{$arrForm.name01|escape}-->" />
<input type="hidden" name="name02" value="<!--{$arrForm.name02|escape}-->" />
</td>
</tr>
<tr>
<td class="fs12n" bgcolor="#ebf9ff" width="150"><span class="red">※</span>フリガナ</td>
<td class="fs12n" bgcolor="#ffffff" width="407">
<!--{$arrForm.kana01|escape}--> <!--{$arrForm.kana02|escape}-->
<input type="hidden" name="kana01" value="<!--{$arrForm.kana01|escape}-->"/>
<input type="hidden" name="kana02" value="<!--{$arrForm.kana02|escape}-->"/>
</td>
</tr>
<tr>
<td class="fs12n" bgcolor="#ebf9ff" width="150"><span class="red">※</span>郵便番å·</td>
<td class="fs12n" bgcolor="#ffffff" width="407">
〒<!--{$arrForm.zip01|escape}-->-<!--{$arrForm.zip02|escape}-->
<input type="hidden" name="zip01" value="<!--{$arrForm.zip01|escape}-->" />
<input type="hidden" name="zip02" value="<!--{$arrForm.zip02|escape}-->" />
<!--{* <input type="button" name="address_input" value="ä½æ‰€å…¥åŠ›" onclick="fnCallAddress('<!--{$smarty.const.URL_INPUT_ZIP}-->', 'zip01', 'zip02', 'pref', 'addr01');" /> *}-->
</td>
</tr>
<tr>
<td class="fs12n" bgcolor="#ebf9ff" width="150"><span class="red">※</span>ã”ä½æ‰€</td>
<td bgcolor="#ffffff" class="fs12n">
<input type="hidden" name="pref" value="<!--{$arrForm.pref|escape}-->" />
<input type="hidden" name="addr01" value="<!--{$arrForm.addr01|escape}-->" />
<input type="hidden" name="addr02" value="<!--{$arrForm.addr02|escape}-->" />
<!--{$arrPref[$arrForm.pref]|escape}--><!--{$arrForm.addr01|escape}--> <!--{$arrForm.addr02|escape}-->
</td>
</tr>
<tr>
<td class="fs12n" bgcolor="#ebf9ff" width="150"><span class="red">※</span>ãŠé›»è©±ç•ªå·</td>
<td class="fs12n" bgcolor="#ffffff" width="407">
<!--{$arrForm.tel01|escape}-->-<!--{$arrForm.tel02|escape}-->-<!--{$arrForm.tel03|escape}-->
<input type="hidden" name="tel01" value="<!--{$arrForm.tel01|escape}-->" />
<input type="hidden" name="tel02" value="<!--{$arrForm.tel02|escape}-->" />
<input type="hidden" name="tel03" value="<!--{$arrForm.tel03|escape}-->" />
</td>
</tr>
<tr>
<td class="fs12n" bgcolor="#ebf9ff" width="150"><span class="red">※</span>メールアドレス</td>
<td class="fs12n" bgcolor="#ffffff" width="407">
<!--{$arrForm.email|escape}-->
<input type="hidden" name="email" value="<!--{$arrForm.email|escape}-->" />
<input type="hidden" name="email02" value="<!--{$arrForm.email02|escape}-->" />
</td>
</tr>
</table>
</td>
</tr>
<tr><td height="15"></td></tr>
<tr>
<td align="center"><input type="button" name="subm1" onclick="return func_return();"value="戻る">　<input type="submit" name="subm2" value="é€ä¿¡"></td>
</tr>
</form>
</table>
<br>
</td>
</tr>
</table>
</body>
</html>