document.write('<!--LP_FORM_START-->');
document.write('			<form method="post" name="form" id="form" action="//ouchi-hikari.net/move/area/confirm.html?lp=area_mail">');
document.write('				<table class="form-table">');
document.write('					<tr class="required-input">');
document.write('					<th><span class="required">必須</span>郵便番号</th>');
document.write('						<td>');
document.write('							<input type="number" id="postcode1" name="postcode1_s" size="10" maxlength="8" placeholder="例）1234567" value="">');
document.write('							<div class="ERR" style="font-weight:bold;"></div>');
document.write('						</td>');
document.write('					</tr>');
document.write('					<tr class="required-input">');
document.write('						<th><span class="required">必須</span>お名前</th>');
document.write('						<td>');
document.write('							<input class="text" type="text" name="name_s" id="name" size="30" placeholder="例）東京太郎" value=""/>');
document.write('							<div class="ERR" style="font-weight:bold;"></div>');
document.write('						</td>');
document.write('					</tr>');
document.write('					<tr class="required-input">');
document.write('						<th><span class="required">必須</span>携帯電話番号</th>');
document.write('						<td>');
document.write('							<input type="tel" name="tel_s" id="tel" placeholder="例）09012345678" value=""/>');
document.write('							<div class="ERR" style="font-weight:bold;"></div>');
document.write('						</td>');
document.write('					</tr>');
document.write('					<tr class="required-input">');
document.write('						<th><span class="required">必須</span>メールアドレス</th>');
document.write('						<td>');
document.write('							<input type="email" name="mail_s" id="email" class="half-width" placeholder="例）example@ouchi-hikari.net" value=""/>');
document.write('							<div class="ERR" style="font-weight:bold;"></div>');
document.write('						</td>');
document.write('					</tr>');
document.write('				</table>');
document.write('				<!-- PC / スマホアクセスを判別（メール件名振り分け） -->');
document.write('				<input type="hidden" name="subject" value="【おうち光ネット_夜間_PC】提供エリア確認メール" />');
document.write('				<!-- 現在の時 -->');
document.write('				<input type="hidden" name="myHour" value="00" />');
document.write('				<!-- ハイフンを削除した電話番号 -->');
document.write('				<input type="hidden" name="tel_link" value="0120255073" />');
document.write('				<!-- 送信元 -->');
document.write('				<input type="hidden" name="type" value="提供エリア確認" id="form_type" />');
document.write('				<!-- 注文番号 -->');
document.write('				<input type="hidden" name="orderid" id="orderid" value="260127-003917" />');
document.write('				<input type="hidden" name="autoReply" value="受け取ります" />');
document.write('				<input type="hidden" name="mailToNum" value="0" />');
document.write('				<input type="hidden" name="action" value="conf" />');
document.write('				<div class="form-row">');
document.write('					<div class="form-section-btn">');
document.write('						<input class="cta-button-area" type="submit" id="btn_areaform_1" name="submit" value="確認画面へ進む" onclick="window.onbeforeunload=null" />');
document.write('					</div>');
document.write('				</div>');
document.write('			</form>');
document.write('			');
document.write('<script>');
document.write('var lpQuery = location.search;');
document.write('var element = document.forms[0]; ');
document.write('element.action = element.getAttribute(\'action\')+lpQuery;');
document.write('</script>');