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animation-txt-cover-03">入会申込みフォーム</span></h1> </div> <p></p><form class="custom-form sign-up" action="/media/works/forms/sign-up/reply" accept-charset="UTF-8" method="post"><input type="hidden" name="authenticity_token" value="jWG3JSJki5_Xndyn-lmTBo18fBO9OIArnwMPNeDQ7FwFxgP_fVAv6a-_a4rQW9ZmvMoBBj8bUvfvxMtPgR2FWw" autocomplete="off" /><input autocomplete="off" type="hidden" value="5" name="form_reply[form_id]" id="form_reply_form_id" /><div class="form-fields"><div class="row form-field"><div class="col-sm-12"><div class="form-group"><input value="39" autocomplete="off" type="hidden" name="form_reply[values_attributes][0][form_field_id]" id="form_reply_values_attributes_0_form_field_id" /><div class="form-group form_radio required"><label>お申込み種別 <small class="text-danger">(必須)</small></label><div><label class="radio-inline"><input required="required" type="radio" value="主催者" name="form_reply[values_attributes][0][value]" id="form_reply_values_attributes_0_value_主催者" />主催者</label><label class="radio-inline"><input required="required" type="radio" value="展示会場" name="form_reply[values_attributes][0][value]" id="form_reply_values_attributes_0_value_展示会場" />展示会場</label><label class="radio-inline"><input required="required" type="radio" value="支援企業" name="form_reply[values_attributes][0][value]" id="form_reply_values_attributes_0_value_支援企業" />支援企業</label></div></div></div></div></div><div class="row form-field"><div class="col-sm-12"><div class="form-group"><input value="40" autocomplete="off" type="hidden" name="form_reply[values_attributes][1][form_field_id]" id="form_reply_values_attributes_1_form_field_id" /><div class="form-group form_text required"><label>団体名・法人名（和文） <small class="text-danger">(必須)</small></label><div><input class="form-control" placeholder="" required="required" type="text" name="form_reply[values_attributes][1][value]" id="form_reply_values_attributes_1_value" /></div></div></div></div></div><div class="row form-field"><div class="col-sm-12"><div class="form-group"><input value="41" autocomplete="off" type="hidden" name="form_reply[values_attributes][2][form_field_id]" id="form_reply_values_attributes_2_form_field_id" /><div class="form-group form_text required"><label>団体名・法人名（フリガナ） <small class="text-danger">(必須)</small></label><div><input class="form-control" placeholder="" required="required" type="text" name="form_reply[values_attributes][2][value]" id="form_reply_values_attributes_2_value" /></div></div></div></div></div><div class="row form-field"><div class="col-sm-12"><div class="form-group"><input value="42" autocomplete="off" type="hidden" name="form_reply[values_attributes][3][form_field_id]" id="form_reply_values_attributes_3_form_field_id" /><div class="form-group form_text "><label>団体名・法人名（英文）</label><div><input class="form-control" placeholder="" type="text" name="form_reply[values_attributes][3][value]" id="form_reply_values_attributes_3_value" /></div></div></div></div></div><div class="row form-field"><div class="col-sm-12"><div class="form-group"><input value="43" autocomplete="off" type="hidden" name="form_reply[values_attributes][4][form_field_id]" id="form_reply_values_attributes_4_form_field_id" /><div class="form-group form_text "><label>職員数・従業員数</label><div><input class="form-control" placeholder="" type="text" name="form_reply[values_attributes][4][value]" id="form_reply_values_attributes_4_value" /></div></div></div></div></div><div class="row form-field"><div class="col-sm-12"><div class="form-group"><input value="44" autocomplete="off" type="hidden" name="form_reply[values_attributes][5][form_field_id]" id="form_reply_values_attributes_5_form_field_id" /><div class="form-group form_text "><label>展示会関連売上高</label><div><input class="form-control" placeholder="" type="text" name="form_reply[values_attributes][5][value]" id="form_reply_values_attributes_5_value" /></div></div></div></div></div><div class="row form-field"><div class="col-sm-12"><div class="form-group"><input value="47" autocomplete="off" type="hidden" name="form_reply[values_attributes][6][form_field_id]" id="form_reply_values_attributes_6_form_field_id" /><div class="form-group form_text "><label>郵便番号</label><div><input class="form-control" placeholder="" type="text" name="form_reply[values_attributes][6][value]" id="form_reply_values_attributes_6_value" /></div></div></div></div></div><div class="row form-field"><div class="col-sm-12"><div class="form-group"><input value="45" autocomplete="off" type="hidden" name="form_reply[values_attributes][7][form_field_id]" id="form_reply_values_attributes_7_form_field_id" /><div class="form-group form_text "><label>所在地</label><div><input class="form-control" placeholder="" type="text" name="form_reply[values_attributes][7][value]" id="form_reply_values_attributes_7_value" /></div></div></div></div></div><div class="row form-field"><div class="col-sm-12"><div class="form-group"><input value="46" autocomplete="off" type="hidden" name="form_reply[values_attributes][8][form_field_id]" id="form_reply_values_attributes_8_form_field_id" /><div class="form-group form_text "><label>電話番号</label><div><input class="form-control" placeholder="" type="text" name="form_reply[values_attributes][8][value]" id="form_reply_values_attributes_8_value" /></div></div></div></div></div><div class="row form-field"><div class="col-sm-12"><div class="form-group"><input value="48" autocomplete="off" type="hidden" name="form_reply[values_attributes][9][form_field_id]" id="form_reply_values_attributes_9_form_field_id" /><div class="form-group form_text "><label>FAX</label><div><input class="form-control" placeholder="" type="text" name="form_reply[values_attributes][9][value]" id="form_reply_values_attributes_9_value" /></div></div></div></div></div><div class="row form-field"><div class="col-sm-12"><div class="form-group"><input value="49" autocomplete="off" type="hidden" name="form_reply[values_attributes][10][form_field_id]" id="form_reply_values_attributes_10_form_field_id" /><div class="form-group form_text "><label>URL</label><div><input class="form-control" placeholder="" type="text" name="form_reply[values_attributes][10][value]" id="form_reply_values_attributes_10_value" /></div></div></div></div></div><div class="row form-field"><div class="col-sm-12"><div class="form-group"><input value="50" autocomplete="off" type="hidden" name="form_reply[values_attributes][11][form_field_id]" id="form_reply_values_attributes_11_form_field_id" /><div class="form-group form_text "><label>協会に代表者として登録する代表者名</label><div><input class="form-control" placeholder="" type="text" name="form_reply[values_attributes][11][value]" id="form_reply_values_attributes_11_value" /></div></div></div></div></div><div class="row form-field"><div class="col-sm-12"><div class="form-group"><input value="51" autocomplete="off" type="hidden" name="form_reply[values_attributes][12][form_field_id]" id="form_reply_values_attributes_12_form_field_id" /><div class="form-group form_text "><label>協会に代表者として登録する代表者名（フリガナ）</label><div><input class="form-control" placeholder="" type="text" name="form_reply[values_attributes][12][value]" id="form_reply_values_attributes_12_value" /></div></div></div></div></div><div class="row form-field"><div class="col-sm-12"><div class="form-group"><input value="52" autocomplete="off" type="hidden" name="form_reply[values_attributes][13][form_field_id]" id="form_reply_values_attributes_13_form_field_id" /><div class="form-group form_text "><label>役職名</label><div><input class="form-control" placeholder="団体・法人の代表者の役職" type="text" name="form_reply[values_attributes][13][value]" id="form_reply_values_attributes_13_value" /></div></div></div></div></div><div class="row form-field"><div class="col-sm-12"><div class="form-group"><input value="53" autocomplete="off" type="hidden" name="form_reply[values_attributes][14][form_field_id]" id="form_reply_values_attributes_14_form_field_id" /><div class="form-group form_sender "><label>E-mail</label><div><input class="form-control" placeholder="団体・法人の代表者のメールアドレス" type="email" name="form_reply[values_attributes][14][value]" id="form_reply_values_attributes_14_value" /></div></div></div></div></div><div class="row form-field"><div class="col-sm-12"><div class="form-group"><input value="54" autocomplete="off" type="hidden" name="form_reply[values_attributes][15][form_field_id]" id="form_reply_values_attributes_15_form_field_id" /><div class="form-group form_text required"><label>代理人（日展協の担当者） <small class="text-danger">(必須)</small></label><div><input class="form-control" placeholder="" required="required" type="text" name="form_reply[values_attributes][15][value]" id="form_reply_values_attributes_15_value" /></div></div></div></div></div><div class="row form-field"><div class="col-sm-12"><div class="form-group"><input value="55" autocomplete="off" type="hidden" name="form_reply[values_attributes][16][form_field_id]" id="form_reply_values_attributes_16_form_field_id" /><div class="form-group form_text "><label>代理人（日展協の担当者）（フリガナ）</label><div><input class="form-control" placeholder="" type="text" name="form_reply[values_attributes][16][value]" id="form_reply_values_attributes_16_value" /></div></div></div></div></div><div class="row form-field"><div class="col-sm-12"><div class="form-group"><input value="56" autocomplete="off" type="hidden" name="form_reply[values_attributes][17][form_field_id]" id="form_reply_values_attributes_17_form_field_id" /><div class="form-group form_text required"><label>役職名 <small class="text-danger">(必須)</small></label><div><input class="form-control" placeholder="代理人（日展協の担当者）の役職" required="required" type="text" name="form_reply[values_attributes][17][value]" id="form_reply_values_attributes_17_value" /></div></div></div></div></div><div class="row form-field"><div class="col-sm-12"><div class="form-group"><input value="57" autocomplete="off" type="hidden" name="form_reply[values_attributes][18][form_field_id]" id="form_reply_values_attributes_18_form_field_id" /><div class="form-group form_text required"><label>E-mail <small class="text-danger">(必須)</small></label><div><input class="form-control" placeholder="代理人（日展協の担当者）のメールアドレス" required="required" type="text" name="form_reply[values_attributes][18][value]" id="form_reply_values_attributes_18_value" /></div></div></div></div></div><div class="row form-field"><div class="col-sm-12"><div class="form-group"><input value="58" autocomplete="off" type="hidden" name="form_reply[values_attributes][19][form_field_id]" id="form_reply_values_attributes_19_form_field_id" /><div class="form-group form_text "><label>事業内容</label><div><input class="form-control" placeholder="" type="text" name="form_reply[values_attributes][19][value]" id="form_reply_values_attributes_19_value" /></div></div></div></div></div><div class="row form-field"><div class="col-sm-12"><div class="form-group"><input value="59" autocomplete="off" type="hidden" name="form_reply[values_attributes][20][form_field_id]" id="form_reply_values_attributes_20_form_field_id" /><div class="form-group form_text "><label>主催する展示会名</label><div><input class="form-control" placeholder="※主催者のみ" type="text" name="form_reply[values_attributes][20][value]" id="form_reply_values_attributes_20_value" /></div></div></div></div></div><div class="row form-field"><div class="col-sm-12"><div class="form-group"><input value="60" autocomplete="off" type="hidden" name="form_reply[values_attributes][21][form_field_id]" id="form_reply_values_attributes_21_form_field_id" /><div class="form-group form_textarea "><label>備考</label><div><textarea class="form-control" rows="5" placeholder="紹介者の社名、お名前等あればご記入ください" name="form_reply[values_attributes][21][value]" id="form_reply_values_attributes_21_value"> </textarea></div></div></div></div></div><div class="row form-field"><div 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