app/template/user_data/mailorder.twig line 1

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  1. {% extends 'default_frame.twig' %}
  3. {% block main %}
  5.  <style>
  6.     .contents-inner .maincontents {
  7.       width: 100%;
  8.       max-width: 890px;
  9.       margin: 0 auto;
  10.     }
  11.   </style>
  12.     <div class="main-top">
  13.         <div id="pagetitle">
  14.             <h2>
  15.                 MAIL ORDER
  16.                 <small>メールでのご注文</small>
  17.             </h2>
  18.             <div class="image">
  19.                 <img src="{{ asset('assets/assets/images/pagetitle-image-contact.jpg') }}">
  20.             </div>
  21.         </div>
  22.     </div>
  24.     <div class="heading1">
  25.         <h2>
  26.             ご注文フォーム
  27.         </h2>
  28.     </div>
  30.     <div class="txtset">
  31.         <p>
  32.             下記の項目をご記入いただき「注文」ボタンを押してください。<br>
  33.             <span class="red">※</span>は必須項目になりますので必ずご入力頂きますようお願いいたします。<br>
  34.             個人情報のお取り扱いについてはプライバシーポリシーをご確認ください。<br>
  35.             <br>
  36.             <span class="red">【ご注意】<br>
  37.                 ※お見積有効期限がすでに過ぎている場合は、経過日数によって改めてお見積書を作成させていただく場合がございます。<br>
  38.                 ※ご注文後の内容変更につきましては、お控えいただけますようお願いいたします。<br>（改めてお見積をご依頼ください）<br>
  39.                 ※内容のご入力にあたり「㈱」や「①②③」などの機種依存文字を使用しないようお願いいたします。お問い合わせいただいた内容が確認できない場合があります。</span>
  40.         </p>
  41.     </div>
  44.     <form class="miniSurveyView" action="/mailorderconfilm/mail.php" method="post" enctype="multipart/form-data">
  45.         <table class="formBlockSurveyTable">
  46.             <tbody>
  48.                 <tr>
  49.                     <td style="vertical-align:top" class="question">
  50.                         <label for="Question">ご注文依頼
  51.                         </label>
  52.                     </td>
  53.                     <td style="vertical-align:top">
  54.                         <select name="ご注文依頼">
  55.                             <option value="ご注文">ご注文</option>
  56.                         </select>
  57.                     </td>
  58.                 </tr>
  60.                 <tr>
  61.                     <td style="vertical-align:top" class="question">
  62.                         <label for="Question2">貴社名&nbsp;<span class="required">*</span>
  63.                         </label>
  64.                     </td>
  65.                     <td style="vertical-align:top"><input name="貴社名" id="Question2" type="text" value="" required="required"></td>
  66.                 </tr>
  68.                 <tr>
  69.                     <td style="vertical-align:top" class="question">
  70.                         <label for="Question3">ご担当者名（お客様名）&nbsp;<span class="required">*</span>
  71.                         </label>
  72.                     </td>
  73.                     <td style="vertical-align:top"><input name="ご担当者名（お客様名）" id="Question3" type="text" value="" required="required"></td>
  74.                 </tr>
  76.                 <tr>
  77.                     <td style="vertical-align:top" class="question">
  78.                         <label for="Question4">メールアドレス&nbsp;<span class="required">*</span>
  79.                         </label>
  80.                     </td>
  81.                     <td style="vertical-align:top"><input name="メールアドレス" id="Question4" type="email" value="" required="required"></td>
  82.                 </tr>
  84.                 <tr>
  85.                     <td style="vertical-align:top" class="question">
  86.                         <label for="Questiontel">電話番号&nbsp;<span class="required">*</span>
  87.                         </label>
  88.                     </td>
  89.                     <td style="vertical-align:top"><input name="電話番号" id="Questiontel" type="tel" value="" required="required"></td>
  90.                 </tr>
  92.                 <tr>
  93.                     <td style="vertical-align:top" class="question">
  94.                         <label for="Question6">見積書番号&nbsp;<span class="required">*</span>
  95.                         </label>
  96.                     </td>
  97.                     <td style="vertical-align:top"><input name="見積書番号" id="Question6" type="text" value="" required="required"></td>
  98.                 </tr>
  101.                 <tr>
  102.                     <td style="vertical-align:top" class="question">
  103.                         <label for="">ご希望納期
  104.                         </label>
  105.                     </td>
  106.                     <td style="vertical-align:top">
  107.                         <select name="ご希望納期">
  108.                             <option value="見積書通りで注文します">見積書通りで注文します</option>
  109.                         </select>
  110.                     </td>
  111.                 </tr>
  113.                 <tr>
  114.                     <td style="vertical-align:top" class="question">
  115.                         <label for="">ご注文商品
  116.                         </label>
  117.                     </td>
  118.                     <td style="vertical-align:top">
  119.                         <select name="ご注文商品">
  120.                             <option value="見積書通りで注文します">見積書通りで注文します</option>
  121.                         </select>
  122.                     </td>
  123.                 </tr>
  126.                 <tr>
  127.                     <td style="vertical-align:top" class="question">
  128.                         <label for="">ご注文数量
  129.                         </label>
  130.                     </td>
  131.                     <td style="vertical-align:top">
  132.                         <select name="ご注文数量">
  133.                             <option value="見積書通りで注文します">見積書通りで注文します</option>
  134.                         </select>
  135.                     </td>
  136.                 </tr>
  138.                 <tr>
  139.                     <td style="vertical-align:top" class="question">
  140.                         <label for="">刷色
  141.                         </label>
  142.                     </td>
  143.                     <td style="vertical-align:top">
  144.                         <select name="刷色">
  145.                             <option value="見積書通りで注文します">見積書通りで注文します</option>
  146.                         </select>
  147.                     </td>
  148.                 </tr>
  150.                 <tr>
  151.                     <td style="vertical-align:top" class="question">
  152.                         <label for="">原稿内容
  153.                         </label>
  154.                     </td>
  155.                     <td style="vertical-align:top">
  156.                         <select name="原稿内容">
  157.                             <option value="見積書通りで注文します">見積書通りで注文します</option>
  158.                         </select>
  159.                     </td>
  160.                 </tr>
  162.                 <tr>
  163.                     <td style="vertical-align:top" class="question">
  164.                         <label for="">御届け先
  165.                         </label>
  166.                     </td>
  167.                     <td style="vertical-align:top">
  168.                         <select name="御届け先">
  169.                             <option value="見積書通りで注文します">見積書通りで注文します</option>
  170.                         </select>
  171.                     </td>
  172.                 </tr>
  174.                 <tr>
  175.                     <td style="vertical-align:top" class="question">
  176.                         <label for="">お支払方法
  177.                         </label>
  178.                     </td>
  179.                     <td style="vertical-align:top">
  180.                         <select name="お支払方法">
  181.                             <option value="見積書通りで注文します">見積書通りで注文します</option>
  182.                         </select>
  183.                     </td>
  184.                 </tr>
  186.                 <tr>
  187.                     <td style="vertical-align:top" class="question">
  188.                         <label for="">その他（記入欄）</label>
  189.                     </td>
  190.                     <td style="vertical-align:top">
  191.                         <textarea name="その他（記入欄）" cols="50" rows="5"></textarea>
  192.                     </td>
  193.                 </tr>
  195.                 <tr>
  196.                     <td>&nbsp;</td>
  197.                     <td>
  198.                         <input class="formBlockSubmitButton ccm-input-button" type="submit" value="注文">
  199.                     </td>
  200.                 </tr>
  202.             </tbody>
  203.         </table>
  204.     </form>
  206. {% endblock %}