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value="" size="30"></td> </tr> <tr> <th rowspan="2" scope="row">菴乗園</th> <td>縲 <input name="zip" type="text" style="ime-mode:disabled;" value="" size="8" maxlength="8"> 驛ｽ驕灘ｺ懃恁 <select name="state" id="prefecture"> <option value="" selected>驕ｸ謚槭＠縺ｦ縺上□縺輔＞</option> <option value=蛹玲ｵｷ驕蹄蛹玲ｵｷ驕訂/option> <option value=髱呈｣ｮ逵屑髱呈｣ｮ逵櫛/option> <option value=遘狗伐逵屑遘狗伐逵櫛/option> <option value=蟯ｩ謇狗恁>蟯ｩ謇狗恁</option> <option value=螻ｱ蠖｢逵屑螻ｱ蠖｢逵櫛/option> <option value=螳ｮ蝓守恁>螳ｮ蝓守恁</option> <option value=遖丞ｳｶ逵屑遖丞ｳｶ逵櫛/option> <option value=譁ｰ貎溽恁>譁ｰ貎溽恁</option> <option value=鄒､鬥ｬ逵屑鄒､鬥ｬ逵櫛/option> <option value=譬?惠逵屑譬?惠逵櫛/option> <option value=闌ｨ蝓守恁>闌ｨ蝓守恁</option> <option value=蝓ｼ邇臥恁>蝓ｼ邇臥恁</option> <option value=譚ｱ莠ｬ驛ｽ>譚ｱ莠ｬ驛ｽ</option> <option value=蜊?痩逵屑蜊?痩逵櫛/option> <option value=逾槫･亥ｷ晉恁>逾槫･亥ｷ晉恁</option> <option value=髟ｷ驥守恁>髟ｷ驥守恁</option> <option value=螻ｱ譴ｨ逵屑螻ｱ譴ｨ逵櫛/option> <option value=遏ｳ蟾晉恁>遏ｳ蟾晉恁</option> <option value=蟇悟ｱｱ逵屑蟇悟ｱｱ逵櫛/option> <option value=遖丈ｺ慕恁>遖丈ｺ慕恁</option> <option value=髱吝ｲ｡逵屑髱吝ｲ｡逵櫛/option> <option value=諢帷衍逵屑諢帷衍逵櫛/option> <option value=貊玖ｳ?逵屑貊玖ｳ?逵櫛/option> <option value=蟯宣?逵屑蟯宣?逵櫛/option> <option value=荳蛾?逵屑荳蛾?逵櫛/option> <option value=蜥梧ｭ悟ｱｱ逵屑蜥梧ｭ悟ｱｱ逵櫛/option> <option value=螂郁憶逵屑螂郁憶逵櫛/option> <option value=莠ｬ驛ｽ蠎廐莠ｬ驛ｽ蠎廂/option> <option value=螟ｧ髦ｪ蠎廐螟ｧ髦ｪ蠎廂/option> <option value=蜈ｵ蠎ｫ逵屑蜈ｵ蠎ｫ逵櫛/option> <option value=魑･蜿也恁>魑･蜿也恁</option> <option value=蟲ｶ譬ｹ逵屑蟲ｶ譬ｹ逵櫛/option> <option value=蠕ｳ蟲ｶ逵屑蠕ｳ蟲ｶ逵櫛/option> <option value=諢帛ｪ帷恁>諢帛ｪ帷恁</option> <option value=鬮倡衍逵屑鬮倡衍逵櫛/option> <option value=鬥吝ｷ晉恁>鬥吝ｷ晉恁</option> <option value=蟯｡螻ｱ逵屑蟯｡螻ｱ逵櫛/option> <option value=蠎?ｳｶ逵屑蠎?ｳｶ逵櫛/option> <option value=螻ｱ蜿｣逵屑螻ｱ蜿｣逵櫛/option> <option value=遖丞ｲ｡逵屑遖丞ｲ｡逵櫛/option> <option value=菴占ｳ?逵屑菴占ｳ?逵櫛/option> <option value=髟ｷ蟠守恁>髟ｷ蟠守恁</option> <option value=螳ｮ蟠守恁>螳ｮ蟠守恁</option> <option value=螟ｧ蛻?恁>螟ｧ蛻?恁</option> <option value=辭頑悽逵屑辭頑悽逵櫛/option> <option value=鮖ｿ蜈仙ｳｶ逵屑鮖ｿ蜈仙ｳｶ逵櫛/option> <option value=豐也ｸ?恁>豐也ｸ?恁</option> </select> </td> </tr> <tr> <td> <input name="address" type="text" class="contactarea" style="ime-mode:active;" value="" size="45"></td> </tr> <tr> <th scope="row">髮ｻ隧ｱ*</th> <td><input name="tel" type="text" class="contactline" style="ime-mode:disabled;" value="" size="30" onblur="Validator.check(this)" /></td> </tr> <tr> <th scope="row">謳ｺ蟶ｯ髮ｻ隧ｱ</th> <td><input name="mobile" type="text" class="contactline" style="ime-mode:disabled;" value="" size="30"></td> </tr> <tr> <th scope="row">FAX</th> <td><input name="fax" type="text" class="contactline" style="ime-mode:disabled;" value="" size="30"></td> </tr> <tr> <th scope="row">E繝｡繝ｼ繝ｫ*</th> <td><input name="eq1" type="text" class="contactline" style="ime-mode:disabled;" value="" size="45" onblur="Validator.check(this, 'equal mail', 'eq2')"><br /> 遒ｺ隱阪?縺溘ａ繧ゅ≧荳?蠎ｦ縺泌?蜉帙￥縺?縺輔＞縲?br /> <input name="eq2" type="text" class="contactline" style="ime-mode:disabled;" value="" size="45" onblur="Validator.check(this, 'equal mail', 'eq1')"></td> </tr> <tr> <th scope="row">縺比ｺ育ｴ?律*</th> <td><input name="year" type="text" style="ime-mode:disabled;" value="" size="8" onblur="Validator.check(this)"> 蟷ｴ <select name="month" onblur="Validator.check(this)"> <option value="" selected> </option> <option value="1">1</option> <option value="2">2</option> <option value="3">3</option> <option value="4">4</option> <option value="5">5</option> <option value="6">6</option> <option value="7">7</option> <option value="8">8</option> <option value="9">9</option> <option value="10">10</option> <option value="11">11</option> <option value="12">12</option> </select> 譛 <select name="day" onblur="Validator.check(this)"> <option value="" selected> </option> <option value="1">1</option> <option value="2">2</option> <option value="3">3</option> <option value="4">4</option> <option value="5">5</option> <option value="6">6</option> <option value="7">7</option> <option value="8">8</option> <option value="9">9</option> <option value="10">10</option> <option value="11">11</option> <option value="12">12</option> <option value="13">13</option> <option value="14">14</option> <option value="15">15</option> <option value="16">16</option> <option value="17">17</option> <option value="18">18</option> <option value="19">19</option> <option value="20">20</option> <option value="21">21</option> <option value="22">22</option> <option value="23">23</option> <option value="24">24</option> <option value="25">25</option> <option value="26">26</option> <option value="27">27</option> <option value="28">28</option> <option value="29">29</option> <option value="30">30</option> <option value="31">31</option> </select> 譌･? <input name="stay" type="text" style="ime-mode:disabled;" value="" size="4" onblur="Validator.check(this)"> 豕懐/td> </tr> <tr> <th class="h_bottom" scope="row">縺雁撫縺?粋繧上○*</th> <td><textarea name="comment" cols="40" rows="10" style="ime-mode:active;" class="contactarea"></textarea></td> </tr> </table> <div align="center"> <input type="submit" name="test" value="蜀?ｮｹ遒ｺ隱咲判髱｢縺ｸ" class="confirm" /> <input 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