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document.write('<script type=\"text/javascript\" src=\"https://assets.bravenet.com/bn/js/emailfwd/bn_email_forms.min.js\"></script><link rel=\"stylesheet\" href=\"https://pub13.bravenet.com/emailfwd/v2/bnet-form.css.php?usernum=1041286426&formid=4156&formpadding=0\"><form method=\"post\" class=\"bnet-form\" enctype=\"multipart/form-data\" action=\"#bn-ajax-post:1041286426:13:4156\"><div class=\"bn-form-header\"><div class=\"bn-form-legend\"><div>【茅ケ崎】お申し込み　2025年5月24日（土）英語の講演</div></div> <div class=\"bn-form-desc\"><p>日本の文化を「英語」と「日本語」で話してみませんか　2024年5月24日（月）13:00-15:00 ');
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document.write('男女共同参画推進センターいこりあ　茅ヶ崎市新栄町12-12 茅ヶ崎市トラストビル４階</p></div></div><div class=\"fields-wrapper ui-sortable-handle\"><label class=\"bn-row\"><span class=\"bn-label\">名前（苗字と名前） <span class=\"bn-required\">*</span></span> <span class=\"bn-input\"><input type=\"text\" name=\"Field-1\" placeholder=\"苗字と名前\" validator=\"\" required=\"required\" value=\"\"></span></label></div><div class=\"fields-wrapper ui-sortable-handle\"><label class=\"bn-row\"><span class=\"bn-label\">名前（カタカナ） <span class=\"bn-required\">*</span></span> <span class=\"bn-input\"><input type=\"text\" name=\"Field-174304592732274\" placeholder=\"カタカナ（苗字と名前）\" validator=\"\" required=\"required\" value=\"\"></span></label></div><div class=\"fields-wrapper ui-sortable-handle\"><label class=\"bn-row\"><span class=\"bn-label\">Eメールアドレス（ご確認） <span class=\"bn-required\">*</span></span> <span class=\"bn-input\"><input type=\"text\" name=\"Field-2\" placeholder=\"Eメールアドレス（ご確認）\" validator=\"email\" required=\"required\" value=\"\"></span></label></div><div class=\"fields-wrapper ui-sortable-handle\"><label class=\"bn-row\"><span class=\"bn-label\">Eメールアドレス <span class=\"bn-required\">*</span></span> <span class=\"bn-input\"><input type=\"text\" name=\"Field-174304598358444\" placeholder=\"Eメールアドレス\" validator=\"email\" required=\"required\" value=\"\"></span></label></div><div class=\"fields-wrapper ui-sortable-handle\"><label class=\"bn-row\"><span class=\"bn-label\">電話番号 <span class=\"bn-required\">*</span></span> <span class=\"bn-input\"><input type=\"text\" name=\"Field-174304604131154\" placeholder=\"電話番号\" validator=\"\" required=\"required\" value=\"\"></span></label></div><div class=\"fields-wrapper ui-sortable-handle\"><label class=\"bn-row\"><span class=\"bn-label\">ご質問等 </span> <span class=\"bn-input\"><textarea name=\"Field-3\" placeholder=\"ご質問\" validator=\"\"></textarea></span></label></div>  <input type=\"hidden\" name=\"carboncopy\" value=\"\"> <input type=\"hidden\" name=\"thankyou\" value=\"\"> <input type=\"hidden\" name=\"thankyoutext\" value=\"Thank you for your form submission\"> <input type=\"hidden\" name=\"subject\" value=\"英比2茅ヶ崎\"><div class=\"bn-form-submit\"><button type=\"submit\" class=\"formbtn\">送信</button></div> <style type=\"text/css\">.bnet-form ::-webkit-input-placeholder {');
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