ÿþ<html> <head> <title>±l­°¹'s ¾\¸ø­</title> </head> <body bgcolor="#FFFFFF" text="#000000"><br> <br><center> This blog is now opend to limited members only. <br> Please fill the application form and submit.<br> I will contact you in a week. </center><br> <br> <form name="formpro" method="post" action="http://www.formpro.jp/form.php?fid=42775"> <table width="600" border="0" align="center" cellpadding="8" cellspacing="0"> <tr> <td width="30%">tÇ„¹(ɲ)</td> <td width="70%"><input name="301683" type="text" value="" size="40" maxlength="100"> <br><font size="1"></font></td> </tr> <tr> <td width="30%">E-mail</td> <td width="70%"><input name="301680_0" value="" type="text" size="40"><br><font size="1"></font></td> </tr> <tr> <td width="30%">‡ºˆ¼ $Æ8Á”Æ?</td> <td width="70%"><input type="radio" name="301703" value="0" checked>°º|·”Æ<br><input type="radio" name="301703" value="1">p¬XÇ ä¹|Ç<br><input type="radio" name="301703" value="2">\Õ üÈÐÅ 2^ÿ3ˆ¼<br><input type="radio" name="301703" value="3">\ÕüÈÐÅ \Õˆ¼<br><input type="radio" name="301703" value="4">ø­ƒ¬ô¼ÀÐ È´Å”Æ<br><font size="1"></font></td> </tr> <tr> <td width="30%">Message</td> <td width="70%"><textarea name="301682" cols="60" rows="15"></textarea><br><font size="1"></font></td> </tr> </table> <p align="center"> <input type="submit" name="Submit" value="Send"> </p> </form> <br> </body> </html>