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株式会社ジェイテクトIT開発センター秋田 | お問い合わせ

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お問い合わせ </div> <div id="contents"> <h1 class="saiyo">お問い合わせ</h1> </div> </div><!--/#content--> <div class="style_page style_form style_contact"> <div id="container"> <div class="contents"> <div class="form_container"> <form method="post" action="contact.php"> <div class="section"> <div class="wrap"> <div class="form_body"> <div class="form_table_group"> <div class="sttl heading">ご連絡先</div> <table class="form_table"> <tr class="required"> <th>お名前</th> <td> <div class="column"> <div class="col"> <div class="input_item_set"> <div class="input_item"><input type="text" name="nm_sei" placeholder="例)山田" value=""></div> </div> </div> <div class="col"> <div class="input_item_set"> <div class="input_item"><input type="text" name="nm_mei" placeholder="例)太郎" value=""></div> </div> </div> </div> </td> </tr> <tr class="required"> <th>フリガナ<br class="view-pc"><span class="sub">(全角カナ)</span></th> <td> <div class="column"> <div class="col"> <div class="input_item_set"> <div class="input_item"><input type="text" name="kn_sei" placeholder="例)ヤマダ" value=""></div> </div> </div> <div class="col"> <div class="input_item_set"> <div class="input_item"><input type="text" name="kn_mei" placeholder="例)タロウ" value=""></div> </div> </div> </div> </td> </tr> <tr class="required"> <th>電話番号</th> <td> <div class="input_item_set"> <div class="input_item"><input type="text" name="tel" placeholder="例)0000-0000-0000" class="w_short" value=""></div> </div> </td> </tr> <tr class="required"> <th>メールアドレス<br class="view-pc"><span class="sub">(半角英数字)</span></th> <td> <div class="input_item_set"> <div class="input_item"><input type="text" name="email" placeholder="例)info@sample.jp" class="w_short" value=""></div> </div> </td> </tr> <tr class="required"> <th>メールアドレス(確認)<br class="view-pc"><span class="sub">(半角英数字)</span></th> <td> <div class="input_item_set"> <div class="input_item"><input type="text" name="email2" placeholder="例)info@sample.jp" class="w_short" value=""></div> </div> </td> </tr> </table> </div> <div class="form_table_group"> <table class="form_table"> <tr class="required"> <th>郵便番号<br class="view-pc"><span class="sub">自動入力</span></th> <td> <div class="input_item_set"> <div class="input_item address_num"><input type="text" id="postcode" name="postcode" placeholder="例)010-0001(全て半角)" value=""><input type="button" id="btn" class="btn btn_autocomplete" value="自動入力" /></div> </div> </td> </tr> <tr class="required"> <th>住所</th> <td> <div class="input_item_set"> <div class="input_item"><input type="text" id="address" name="address" placeholder="例)秋田県秋田市中通四丁目2番7号 日本生命秋田中央通ビル3F" value=""></div> </div> </td> </tr> <tr> <th>会社名・団体名</th> <td> <div class="input_item_set"> <div class="input_item"><input type="text" name="company" placeholder="例)株式会社ジェイテクトIT開発センター秋田" value=""></div> </div> </td> </tr> <tr> <th>所属部署名</th> <td> <div class="input_item_set"> <div class="input_item"><input type="text" name="department" placeholder="" value=""></div> </div> </td> </tr> </table> </div> <div class="form_table_group"> <table class="form_table"> <tr class="required"> <th class="qstth">お問い合わせ内容をご記入ください。</th> </tr> <tr> <th class="qstth"> <div class="input_item_set"> <div class="input_item"><textarea name="content"></textarea></div> </div> </th> </tr> </table> </div> </div> </div> </div> <div class="section"> <div class="wrap"> <div class="form_body"> <div class="form_table_group topline"> <table class="form_table"> <tr> <th>当社の<a href="../privacy.html" class="privacy" target="_blank">個人情報保護方針</a>についてご同意いただいた上で、下記の事項をご入力下さい。</th> </tr> </table> </div> </div> </div> </div> <div class="section form_actions"> <div class="wrap"> <ul class="btn_list"> <li><div class="btn default btn_white arrow btn_submit"><input type="submit" value="入力を確認する"></div></li> </ul> </div> </div> <input type="hidden" name="mode" value="confirm"> <input type="hidden" name="token" value="f7b90b809fbfddf5e2c9e5759d06ddaf380ef2c3" /> </form> </div> </div><!-- /.contents --> </div><!-- /#container --> </div><!-- /.style_page .style_form .style_contact --> <script>js_footer('../');</script> </div><!-- /#wrap --> <script src="//lib-3pas.admatrix.jp/3pas/js/AdMatrixAnalyze.min.js"></script> <script type="text/javascript"> (function(){ var p = (("https:" == document.location.protocol) ? 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