document.write("<script language=\"javascript\" type=\"text/javascript\" src=\"http://www.letopo.com/statics/js/dialog.js\"></script><script type=\"text/javascript\" src=\"http://www.letopo.com/statics/js/dialog.js\"></script><div class=\"zsjm3nr\"><form method=\"post\" action=\"http://www.letopo.com/index.php?m=formguide&c=index&a=show&formid=17&siteid=1\" name=\"myform\" id=\"myform\">   <div class=\"zsjm3nr_title\">您想加盟的项目 :<span class=\"xiaoxinghao\"></span></div><div class=\"zsjm3nr_1\"><table width=\"100%\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\"><tr><td  height=\"68\" valign=\"top\"><input type=\"radio\" name=\"info[jiamengxiangmu]\" id=\"jiamengxiangmu_1\" value=\"1\" checked=\"checked\"/> 乐同 · 健康书桌椅专卖店</td></tr><tr><td  height=\"68\" valign=\"top\"><input name=\"info[jiamengxiangmu]\" id=\"jiamengxiangmu_2\" value=\"2\" type=\"radio\" /> 乐同 · 智造基地机器人培训中心</td></tr><tr><td  height=\"68\" valign=\"top\"><input name=\"info[jiamengxiangmu]\" id=\"jiamengxiangmu_3\" value=\"3\" type=\"radio\" /> 乐学馆 · 乐同健康书桌椅专卖店+乐同智造基地</td></tr></table></div><div class=\"zsjm3nr_title\">您的资料 :</div><div class=\"zsjm3nr_2\"><table width=\"100%\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">  <tr>    <td width=\"128\" height=\"25\"><div class=\"zsjm3nr_21\">姓名 :<span class=\"xiaoxinghao\"></span></div></td>    <td width=\"128\"><div class=\"zsjm3nr_21\">性别 :<span class=\"xiaoxinghao\"></span></div></td>    <td width=\"128\"><div class=\"zsjm3nr_21\">年龄 :<span class=\"xiaoxinghao\"></span></div></td>    <td width=\"175\"><div class=\"zsjm3nr_21\">联系电话 :<span class=\"xiaoxinghao\"></span></div></td>    <td width=\"175\"><div class=\"zsjm3nr_21\">QQ或邮箱 :<span class=\"xiaoxinghao\"></span></div></td>    <td><div class=\"zsjm3nr_21\">目前从事职业 :</div></td>  </tr>  <tr>    <td height=\"30\"><input type=\"text\"  name=\"info[name]\" id=\"name\" class=\"zsjm3nr_2_w110k\"/></td>    <td><input type=\"radio\" name=\"info[ch]\" id=\"ch_1\" value=\"1\" checked=\"checked\"/> 先生 <input type=\"radio\" name=\"info[ch]\" id=\"ch_2\" value=\"2\"/> 女士</td>    <td><input type=\"text\" name=\"info[age]\" id=\"age\" class=\"zsjm3nr_2_w110k\"/></td>    <td><input type=\"text\" name=\"info[tel]\" id=\"tel\"  class=\"zsjm3nr_2_w156k\"/></td>    <td><input type=\"text\"  name=\"info[email]\" id=\"email\" class=\"zsjm3nr_2_w156k\"/></td>    <td><input type=\"text\" name=\"info[mqcszy]\" id=\"mqcszy\"  class=\"zsjm3nr_2_w121k\"/></td>  </tr></table></div><div class=\"zsjm3nr_3\"><table width=\"100%\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">  <tr>    <td width=\"600\" height=\"25\"><div class=\"zsjm3nr_21\">希望加盟的地区 :<span class=\"xiaoxinghao\"></span></div></td>    <td><div class=\"zsjm3nr_21\">通过何种途径了解到乐同品牌 :</div></td>  </tr>  <tr>    <td height=\"30\"><input type=\"text\" name=\"info[sheng]\" id=\"sheng\" class=\"zsjm3nr_3_w88k\"/> 省 <input type=\"text\" name=\"info[shi]\" id=\"shi\"  class=\"zsjm3nr_3_w88k\"/> 市 <input type=\"text\" name=\"info[qu]\" id=\"qu\" class=\"zsjm3nr_3_w88k\"/> 区 <input type=\"text\" name=\"info[add]\" id=\"add\" class=\"zsjm3nr_3_w236k\"/></td>    <td><input type=\"text\" name=\"info[tujing]\" id=\"tujing\"  class=\"zsjm3nr_3_w254k\"/></td>  </tr></table></div><div class=\"zsjm3nr_4\"><div class=\"zsjm3nr_41\">可投入乐同项目的资金(RMB) :<span class=\"xiaoxinghao\"></span> <input type=\"text\" name=\"info[trzj]\" id=\"trzj\"   class=\"zsjm3nr_3_w88k\"/> 元 </div></div><div class=\"zsjm3nr_title\">城市基本情况 :</div><div class=\"zsjm3nr_5\"><table width=\"100%\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">  <tr>    <td width=\"128\" height=\"25\"><div class=\"zsjm3nr_21\">所在城市人口 :</div></td>    <td width=\"150\"><div class=\"zsjm3nr_21\">繁华街道名称 :<span class=\"xiaoxinghao\"></span></div></td>    <td width=\"158\"><div class=\"zsjm3nr_21\">主要商场名称 :<span class=\"xiaoxinghao\"></span></div></td>    <td><div class=\"zsjm3nr_21\">拟加盟门店选址 :<span class=\"xiaoxinghao\"></span></div></td>  </tr>  <tr>    <td height=\"30\"><input type=\"text\"   name=\"info[szcsrk]\" id=\"szcsrk\" class=\"zsjm3nr_2_w110k\"/></td>    <td><input type=\"text\" name=\"info[fhjdmc]\" id=\"fhjdmc\" class=\"zsjm3nr_4_w130k\"/></td>    <td><input type=\"text\" name=\"info[zyscmc]\" id=\"zyscmc\" class=\"zsjm3nr_4_w138k\"/></td>    <td><input type=\"text\" name=\"info[njmmdxz]\" id=\"njmmdxz\" class=\"zsjm3nr_4_w416k\"/></td>  </tr></table></div><div class=\"zsjm3nr_6\"><table width=\"100%\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">  <tr>    <td width=\"33%\" height=\"25\"><div class=\"zsjm3nr_21\">当地支柱产业 :</div></td>    <td width=\"33%\"><div class=\"zsjm3nr_21\">当地儿童产业情况 / 消费水平情况 :</div></td>    <td ><div class=\"zsjm3nr_21\">您的意见或问题 :</div></td>  </tr>  <tr>    <td height=\"120\"><textarea name=\"info[ddzzcy]\" id=\"ddzzcy\" class=\"zsjm3nr_6_w274h100k\"></textarea></td>    <td><textarea name=\"info[ddetcy]\" id=\"ddetcy\"  class=\"zsjm3nr_6_w274h100k\"></textarea></td>    <td><textarea name=\"info[area]\" id=\"area\" class=\"zsjm3nr_6_w274h100k\"></textarea></td>  </tr></table></div><div class=\"zsjm3nr_7\"><div class=\"zsjm3nr_71\"><div class=\"zsjmnr_52\" style=\"float:left;\">            <ul>            <li><a href=\"http://www.letopo.com/index.php?m=content&c=index&a=lists&catid=30\"><img src=\"images/zsjmnr_521.png\" height=\"31\" /></a></li>            <li><img src=\"images/zsjmnr_52.png\" height=\"31\" /></li>            <li><a href=\"http://www.letopo.com/index.php?m=content&c=index&a=lists&catid=31\"><img src=\"images/zsjmnr_523.png\" height=\"31\" /></a></li>            </ul>            </div>            </div><div class=\"zsjm3nr_72\">        <div class=\"zsjm3nr_721\">        <p style=\"color:#222bab;\">非常感谢您对乐同的支持，我们将尽快与您联系！</p>        <p>Thank you very much for your support to us,<br />We will contact you as soon as possible!</p>        </div>        <div class=\"zsjm3nr_722\"><input type=\"submit\"  name=\"dosubmit\" id=\"dosubmit\" value=\"\" class=\"zsjm3nr_tj\"/></div>    </div><div class=\"zsjm3nr_73\"><img src=\"http://www.letopo.com/uploadfile/2015/0923/20150923102003253.png\" height=\"40\" /></div></div></form></div>");