<form action="https://39auto.biz/0325/planmail.php " method="post">
<input type="hidden" name="mcode" value="SJIS">
<input type="hidden" name="pid" value="2">
<table width="520" cellpadding="3" cellspacing="1" border="0" bgcolor="#aaaaaa">
<tr>
<td align="center" colspan="2" bgcolor="#e5e5e5"><font size="-1" color="#666666"><b>伸びる子のママになる絶対に知っておくとよい１２のコツ</b></font><br></td>
</tr>
<tr>
<td bgcolor="#f2f2f2" align="center" width="120"><font size="-1" color="#666666"><b>お名前</b></font><br></td>
<td bgcolor="#fafafa" width="400">
<input type="text" name="name1" size="30">
</td>
</tr>
<tr>
<td bgcolor="#f2f2f2" align="center" width="120"><font size="-1" color="#666666"><b>e-mail（携帯・PC）</b></font><br></td>
<td bgcolor="#fafafa" width="400">
<input type="text" name="email" size="30"><font size="-1" color="#666666"> higashi@kosodate-up.com</font >
</td>
</tr>
</table>
<table width="520">
<tr>
<td align="center"><input type="submit" name="sbm" value="登 録"></td>
</tr>
</table>
</form>