-=[ Mr. Bumblebee ]=-
_Indonesia_
<!-- BEGIN OF FORM -->
<form method="post" action="$TOTAL[cmnnb]" onsubmit=" return _chkForm(this); ">
<input type="hidden" name="mode" value="insert">
<!-- ¿©±âºÎÅÍ -->
<table class="cata" width="100%" cellSpacing="0" cellPadding="0" style="BORDER-COLLAPSE: collapse;border:1px solid #ccc" frame=hsides rules="rows">
<col align="center" width="80" bgcolor="#e4ecf2">
<col >
<col align="center" width="80" bgcolor="#e4ecf2">
<col>
<TR>
<td height="30" bgcolor="#e4ecf2" class="title"><STRONG>¼º ¸í</STRONG></TD>
<TD colspan="3" class="pd_l8"><input type="text" name="username" size="30" maxlength="100" class="form" required emsg=" ¼º¸íÀ» ÀÔ·ÂÇØÁÖ¼¼¿ä "></TD>
</TR>
<TR>
<td height="30" class="title"><STRONG>ÇÚµåÆù</STRONG></TD>
<TD class="pd_l8"><input type="text" name="hp1" style="width:60px; " class="form" maxlength=3 required emsg=" ÇÚµåÆù¹øÈ£¸¦ ÀÔ·ÂÇØÁÖ¼¼¿ä " vtype="phone" group="hp"> - <input type="text" name="hp2" style="width:60px; " class="form" maxlength=4 required emsg=" ÇÚµåÆù¹øÈ£¸¦ ÀÔ·ÂÇØÁÖ¼¼¿ä " vtype="phone" group="hp"> - <input type="text" name="hp3" style="width:60px; " class="form" maxlength=4 required emsg=" ÇÚµåÆù¹øÈ£¸¦ ÀÔ·ÂÇØÁÖ¼¼¿ä " vtype="phone" group="hp"></TD>
<TD class="title"><b>¿¬¶ôó</b></TD>
<TD class="pd_l8"><input type="text" name="tel1" style="width:60px; " class="form" maxlength=3 required emsg=" ¿¬¶ôó¸¦ ÀÔ·ÂÇØÁÖ¼¼¿ä " vtype="phone" group="tel"> - <input type="text" name="tel2" style="width:60px; " class="form" maxlength=4 required emsg=" ¿¬¶ôó¸¦ ÀÔ·ÂÇØÁÖ¼¼¿ä " vtype="phone" group="tel"> - <input type="text" name="tel3" style="width:60px; " class="form" maxlength=4 required emsg=" ¿¬¶ôó¸¦ ÀÔ·ÂÇØÁÖ¼¼¿ä " vtype="phone" group="tel"></TD>
</TR>
<TR>
<td height="30" class="title"><b>ÁÖ¼Ò</b></TD>
<TD colSpan="3" class="pd8"><input class=form style="width: 50px" readonly name=zip1 emsg=" ÁÖ¼Ò¸¦ °Ë»öÇØÁÖ¼¼¿ä " required>
-
<input class=form style="width: 50px" readonly name=zip2 emsg=" ÁÖ¼Ò¸¦ °Ë»öÇØÁÖ¼¼¿ä " required>
<a href="javascript:popzip('zip1','zip2','addr1');"><img src="/img/bt/bt_addsch.gif" align=absmiddle border=0 alt=¿ìÆí¹øÈ£°Ë»ö ></a><br>
<input class=form style="width: 150px" readonly name=addr1 emsg=" ÁÖ¼Ò¸¦ °Ë»öÇØÁÖ¼¼¿ä " required>
<input class=form style="width: 200px" name=addr2 emsg=" ÁÖ¼Ò¸¦ ÀÔ·ÂÇØÁÖ¼¼¿ä " required></TD>
</TR>
<TR>
<td height="30" class="title"><b>¸Þ¸ð</b></TD>
<TD colSpan="3" class="pd8"><textarea name="contents" cols="80" rows="10" style="width:100%" class="form"></textarea></TD>
</TR>
</table>
<br><br>
<table width="96%">
<tr>
<td height="30" align="center"><input type="image" src="/img/bt/bt_confirm.gif"> <a href="javascript:history:go(-1);"><img src="/img/bt/bt_cancel.gif"></a></td>
</tr>
</table>
</form>
<!-- END OF FORM -->
Copyright © 2017 || Recoded By Mr.Bumblebee