<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN"
"http://www.w3.org/TR/html4/loose.dtd">
<html>
<head>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8">
<title>リクエスト条件指定</title>
<link href="./css/default2.css" rel="stylesheet" type="text/css">
</head>

<body>
<form action="{$scriptName}" id="form1" method="POST">
<input type="hidden" name="action" value="wanted_itemrequest_step_complete">
<table width="600" border="0" cellspacing="0" cellpadding="6">
  <tr>
    <td colspan="2"><table width="578" border="0" cellpadding="0" cellspacing="1" bgcolor="a69649">
      <tr>
        <td width="561" bgcolor="#f7f5ed"><table width="570" border="0" cellpadding="0" cellspacing="0">
            <tr>
              <td width="570"><table width="570" border="0" cellpadding="1" cellspacing="0">
                  <tr>
                    <td colspan="3"><span class="moji4_1"><img src="./images/spacer.gif" width="100" height="5"></span></td>
                  </tr>
                  <tr>
                    <td width="10"><img src="./images/spacer.gif" width="10" height="8"></td>
                    <td width="129"><img src="./img/sample/21.jpg" alt="商品画像" width="120" height="170"></td>
                    <td width="420" align="left" valign="top"><table width="420" border="0" cellspacing="0" cellpadding="5">
                      <tr>
                        <td colspan="2" class="moji4_1"><span class="title1">リクエストする商品</span></td>
                        </tr>
                      <tr>
                        <td colspan="2" class="moji4_1"><img src="./images/spacer.gif" width="100" height="5"></td>
                      </tr>
                      <tr>
                        <td width="80" class="moji4_1">商品タイトル</td>
                      <td width="320" class="moji4">商品タイトル１</td>
                      </tr>
                      <tr>
                        <td class="moji4_1">メーカー</td>
                      <td width="320" class="moji4">メーカー１</td>
                      </tr>
                      <tr>
                        <td class="moji4_1">レーベル</td>
                        <td class="moji4">レーベル</td>
                      </tr>
                    </table></td>
                  </tr>
                  <tr>
                    <td colspan="3"><span class="moji4_1"><img src="./images/spacer.gif" width="100" height="5"></span></td>
                  </tr>
              </table></td>
            </tr>
        </table></td>
      </tr>
    </table></td>
  </tr>
  <tr>
    <td colspan="2"><span class="title1"><img src="./images/spacer.gif" width="500" height="1"></span></td>
  </tr>
  <tr>
    <td width="170" align="left" valign="top" class="moji4_1"><div align="right">リクエスト商品の<br>
      コンディション最低ライン
    </div>
    <div align="right"></div></td>
    <td width="406"><select name="select">
	<option>指定なし
	<option>可
	<option>良い
	<option>非常に良い
	<option>ほぼ新品
	<option>新品
    </select></td>
  </tr>
  <tr>
    <td><div align="right">
      <table width="150" border="0" cellspacing="2" cellpadding="0">
        <tr>
          <td><div align="right" class="moji4_1">定価</div></td>
        </tr>
        <tr>
          <td><div align="right" class="moji4_1">現在の最低価格</div></td>
        </tr>
      </table>
    </div></td>
  <td><table width="190" border="0" cellspacing="2" cellpadding="0">
    <tr>
      <td class="price1">￥ 4,218</td>
    </tr>
    <tr>
      <td class="price1">￥ 3,853</td>
    </tr>
  </table></td>
  </tr>
  <tr>
    <td class="moji4_1"><div align="right">リクエスト価格（上限）<br>
      （送料込み）
    </div></td>
  <td><input type="text" name="textfield"></td>
  </tr>
  <tr>
    <td class="moji4_1"><div align="right">リクエストの有効期限</div></td>
  <td><select name="select">
	<option>4週間
	<option>8週間
	<option>12週間
  </select></td>
  </tr>
  <tr class="moji1">
    <td colspan="2"><img src="./images/border1.gif" width="582" height="1"></td>
  </tr>
  <tr>
    <td align="left" valign="top"><div align="right" class="moji4_1">リクエストタイプ</div></td>
  <td><table width="400" border="0" cellspacing="2" cellpadding="0">
    <tr>
      <td width="20"><input name="radiobutton" type="radio" value="radiobutton"></td>
    <td colspan="2" class="moji4">とりあえず、探してみる</td>
    </tr>
    <tr>
      <td>&nbsp;</td>
    <td width="20"><input type="checkbox" name="checkbox" value="checkbox"></td>
    <td width="352" class="moji4">発見時にメール通知する</td>
    </tr>
    <tr>
      <td colspan="3"><img src="./images/spacer.gif" width="100" height="8"></td>
      </tr>
    <tr>
      <td><input name="radiobutton" type="radio" value="radiobutton"></td>
    <td colspan="2" class="moji4">絶対買う！　 ※購入者情報を登録していない方は選択できません</td>
    </tr>
  </table></td>
  </tr>
  <tr class="moji1">
    <td colspan="2"><img src="./images/border1.gif" width="582" height="1"></td>
  </tr>
  <tr class="moji1">
    <td colspan="2">&nbsp;</td>
  </tr>
  <tr>
    <td colspan="2">
      <div align="center">        
        <table width="115" border="0" cellspacing="0" cellpadding="0">
          <tr>
            <td width="50"><input type="submit" name="Submit" value="確認"></td>
            <td width="15">&nbsp;</td>
            <td width="50"><input type="button" name="Submit" value="戻る"></td>
          </tr>
        </table>
      </div></td>
  </tr>
</table>
</body>
</html>
