<link rel="stylesheet" type="text/css" href="https://jsan.biz/neo/css/formcss/theme2.css" />

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<script src="https://ajax.googleapis.com/ajax/libs/jquery/3.4.1/jquery.min.js"></script>
<script src="https://cdnjs.cloudflare.com/ajax/libs/jquery-validate/1.19.0/jquery.validate.min.js" integrity="sha256-bu/BP02YMudBc96kI7yklc639Mu4iKGUNNcam8D2nLc=" crossorigin="anonymous"></script>
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<script type="text/javascript">
    
    //<![CDATA[
    $(document).ready(function() {
        $("#mailform").validate({
            errorClass: "JQVError",
            rules: {
                
                
                email: {required: true, email: true},
                
                
                name: {required: true},
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
            }});
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</script>
<style>
    
    .displayInline{ display:inline; }
    
</style>
<form method=post id="mailform" action="https://jsan.biz/neo/usrctrl.php">
    <input type="hidden" name="mag_id" value="6" />
    <input type="hidden" name="form_id" value="5" />
                        <input type="hidden" name="charset" value="u" />
                                    <input type="hidden" name="type" value="siteblog" />
                <div class="mailform_body">
        <div id="magazine_name">【ケアマネ合格】一問一答メール登録</div>
        <div class="mailform_clear"></div>
                                    <input type="hidden" id="act" name="act" value="add" />
                                                        <span class="mailform_l">
		<span class="require_mark">*</span>                    <label for="email">メールアドレス:</label></span><div class="mailform_r">
                <input type="text" id="email" name="email" value="" /></div>
                <div class="mailform_clear"></div>
                                                        <span class="mailform_l">
		<span class="require_mark">*</span>                    <label for="name">名前:</label></span><div class="mailform_r">
                <input type="text" id="name" name="name" value="" /></div>
                <div class="mailform_clear"></div>
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                <div class="mailform_submit"><input class="submitButton" type="submit" value="送信"></div>
</div>
                        </div>
</form>
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