Form transmission of reservation
*
: indispensable input
#
: Either is indispensable.
Reservation day
*
day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
month
Jan1
Feb2
Mar3
Apr4
May5
Jun6
Jul7
Aug8
Sep9
Oct10
Nov11
Dec12
year
2011
2012
Number of reservations
*
1
2
3
4
5
Type
*
タイプ1
タイプ2
Name
*
Sex
Male|
Female
Zip-code
*
Prefecture
*
Address
*
Telephone number
#
Mobile-phone number
#
Facsimile number
Mail Address
*
Mail Address
*
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Communication column
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