{"id":14,"date":"2013-09-06T15:27:18","date_gmt":"2013-09-06T06:27:18","guid":{"rendered":"http:\/\/www.kusemi.ac.jp\/clark-kurume\/?page_id=14"},"modified":"2023-05-24T10:03:34","modified_gmt":"2023-05-24T01:03:34","slug":"%e8%b3%87%e6%96%99%e8%ab%8b%e6%b1%82","status":"publish","type":"page","link":"https:\/\/www.kusemi.ac.jp\/clark-kurume\/form.html","title":{"rendered":"\u8cc7\u6599\u8acb\u6c42"},"content":{"rendered":"<h2 class=\"entry-title\">\u8cc7\u6599\u8acb\u6c42<\/h2>\n<p class=\"fs15 ma-normal\">\u304a\u554f\u5408\u305b\u96fb\u8a71\u756a\u53f7\u3000 0942-35-4943<br \/>\n\u3010\u53d7\u4ed8\u6642\u9593\u3011\u6708\u66dc\uff5e\u91d1\u66dc9\uff1a00\uff5e18\uff1a00\u3001\u571f\u66dc11\uff1a00\uff5e16\uff1a00<br \/>\n\u203b\u6642\u9593\u5916\u307e\u305f\u306f\u65e5\u795d\u65e5\u306e\u8cc7\u6599\u8acb\u6c42\u53d7\u4ed8\u3000TEL 0942-35-4970\uff08\u4e45\u7559\u7c73\u30bc\u30df\u30ca\u30fc\u30eb\u6cd5\u4eba\u672c\u90e8\uff09<\/p>\n\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f370-o1\" lang=\"ja\" dir=\"ltr\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/clark-kurume\/wp-json\/wp\/v2\/pages\/14#wpcf7-f370-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"\u30b3\u30f3\u30bf\u30af\u30c8\u30d5\u30a9\u30fc\u30e0\" novalidate=\"novalidate\" data-status=\"init\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"370\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"5.8.5\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"ja\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f370-o1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/div>\n<h2 class=\"entry-title\">\u8cc7\u6599\u8acb\u6c42\u30d5\u30a9\u30fc\u30e0\n<\/h2>\n<table>\n\t<tr>\n\t\t<th class=\"bold\">\n\t\t\t<p>\u8cc7\u6599\u8acb\u6c42\u8005\u6c0f\u540d (\u5fc5\u9808)\n\t\t\t<\/p>\n\t\t<\/th>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-name\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-name\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<th class=\"bold\">\n\t\t\t<p>\u30d5\u30ea\u30ac\u30ca (\u5fc5\u9808)\n\t\t\t<\/p>\n\t\t<\/th>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"furigana\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"furigana\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<th class=\"bold\">\n\t\t\t<p>\u30e1\u30fc\u30eb\u30a2\u30c9\u30ec\u30b9 (\u5fc5\u9808)\n\t\t\t<\/p>\n\t\t<\/th>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-email\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"your-email\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<th class=\"bold\">\n\t\t\t<p>\u96fb\u8a71\u756a\u53f7 (\u5fc5\u9808)\n\t\t\t<\/p>\n\t\t<\/th>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"tel\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"tel\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<th class=\"bold\">\n\t\t\t<p>\u751f\u5f92\u69d8\u3068\u306e\u7d9a\u67c4 (\u5fc5\u9808)\n\t\t\t<\/p>\n\t\t<\/th>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"relation\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"relation\"><option value=\"\u672c\u4eba\">\u672c\u4eba<\/option><option value=\"\u7236\u6bcd\">\u7236\u6bcd<\/option><option value=\"\u5144\u5f1f\">\u5144\u5f1f<\/option><option value=\"\u62c5\u4efb\">\u62c5\u4efb<\/option><option value=\"\u305d\u306e\u4ed6\">\u305d\u306e\u4ed6<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<th class=\"bold\">\n\t\t\t<p>\u90f5\u4fbf\u756a\u53f7 (\u5fc5\u9808)\n\t\t\t<\/p>\n\t\t<\/th>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"yuubin\"><input size=\"10\" maxlength=\"10\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"yuubin\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<th class=\"bold\">\n\t\t\t<p>\u9001\u4ed8\u5148\u4f4f\u6240 (\u5fc5\u9808)\n\t\t\t<\/p>\n\t\t<\/th>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"jyusho\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"jyusho\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<th class=\"bold\">\n\t\t\t<p>\u751f\u5f92\u6c0f\u540d (\u5fc5\u9808)\n\t\t\t<\/p>\n\t\t<\/th>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"student-name\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"student-name\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<th class=\"bold\">\n\t\t\t<p>\u30d5\u30ea\u30ac\u30ca (\u5fc5\u9808)\n\t\t\t<\/p>\n\t\t<\/th>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"student-name-furigana\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"student-name-furigana\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<th class=\"bold\">\n\t\t\t<p>\u751f\u5f92\u6027\u5225 (\u5fc5\u9808)\n\t\t\t<\/p>\n\t\t<\/th>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"sex\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"sex[]\" value=\"\u7537\u6027\" \/><span class=\"wpcf7-list-item-label\">\u7537\u6027<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"sex[]\" value=\"\u5973\u6027\" \/><span class=\"wpcf7-list-item-label\">\u5973\u6027<\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<th class=\"bold\">\n\t\t\t<p>\u751f\u5e74\u6708\u65e5 (\u5fc5\u9808)\n\t\t\t<\/p>\n\t\t<\/th>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"b-year\"><input size=\"10\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"b-year\" \/><\/span> \u5e74 <span class=\"wpcf7-form-control-wrap\" data-name=\"b-month\"><input size=\"4\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"b-month\" \/><\/span> \u6708 <span class=\"wpcf7-form-control-wrap\" data-name=\"b-day\"><input size=\"4\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"b-day\" \/><\/span> \u65e5\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<th class=\"bold\">\n\t\t\t<p>\u751f\u5f92\u5b66\u5e74 (\u5fc5\u9808)\n\t\t\t<\/p>\n\t\t<\/th>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"school\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"school\"><option value=\"\u4e2d\u5b661\u5e74\">\u4e2d\u5b661\u5e74<\/option><option value=\"\u4e2d\u5b662\u5e74\">\u4e2d\u5b662\u5e74<\/option><option value=\"\u4e2d\u5b663\u5e74\">\u4e2d\u5b663\u5e74<\/option><option value=\"\u4e2d\u5b66\u65e2\u5352\">\u4e2d\u5b66\u65e2\u5352<\/option><option value=\"\u9ad8\u6821\uff11\u5e74\u5728\u5b66\">\u9ad8\u6821\uff11\u5e74\u5728\u5b66<\/option><option value=\"\u9ad8\u6821\uff12\u5e74\u5728\u5b66\">\u9ad8\u6821\uff12\u5e74\u5728\u5b66<\/option><option value=\"\u9ad8\u6821\uff13\u5e74\u5728\u5b66\">\u9ad8\u6821\uff13\u5e74\u5728\u5b66<\/option><option value=\"\u9ad8\u6821\uff11\u5e74\u9000\u5b66\">\u9ad8\u6821\uff11\u5e74\u9000\u5b66<\/option><option value=\"\u9ad8\u6821\uff12\u5e74\u9000\u5b66\">\u9ad8\u6821\uff12\u5e74\u9000\u5b66<\/option><option value=\"\u9ad8\u6821\uff13\u5e74\u9000\u5b66\">\u9ad8\u6821\uff13\u5e74\u9000\u5b66<\/option><option value=\"\u305d\u306e\u4ed6\">\u305d\u306e\u4ed6<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<th class=\"bold\">\n\t\t\t<p>\u751f\u5f92\u5b66\u6821\u540d (\u5fc5\u9808)\n\t\t\t<\/p>\n\t\t<\/th>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"school-name\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"school-name\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<th class=\"bold\">\n\t\t\t<p>\u8cc7\u6599\u8acb\u6c42\u3055\u308c\u308b\u304d\u3063\u304b\u3051\n\t\t\t<\/p>\n\t\t<\/th>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"unq\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"unq\"><option value=\"\u9ad8\u6821\u306e\u5148\u751f\u304b\u3089\u805e\u3044\u305f\">\u9ad8\u6821\u306e\u5148\u751f\u304b\u3089\u805e\u3044\u305f<\/option><option value=\"\u4e2d\u5b66\u6821\u306e\u5148\u751f\u304b\u3089\u805e\u3044\u305f\">\u4e2d\u5b66\u6821\u306e\u5148\u751f\u304b\u3089\u805e\u3044\u305f<\/option><option value=\"\u53cb\u4eba\u30fb\u77e5\u4eba\u304b\u3089\u805e\u3044\u305f\">\u53cb\u4eba\u30fb\u77e5\u4eba\u304b\u3089\u805e\u3044\u305f<\/option><option value=\"\u4fdd\u8b77\u8005\u304b\u3089\u805e\u3044\u305f\">\u4fdd\u8b77\u8005\u304b\u3089\u805e\u3044\u305f<\/option><option value=\"\u5144\u5f1f\u59c9\u59b9\u304b\u3089\u805e\u3044\u305f\">\u5144\u5f1f\u59c9\u59b9\u304b\u3089\u805e\u3044\u305f<\/option><option value=\"\u65b0\u805e\u3067\u8a18\u4e8b\u3092\u898b\u305f\">\u65b0\u805e\u3067\u8a18\u4e8b\u3092\u898b\u305f<\/option><option value=\"\u60c5\u5831\u8a8c\u3067\u898b\u305f\">\u60c5\u5831\u8a8c\u3067\u898b\u305f<\/option><option value=\"\u99c5\u30dd\u30b9\u30bf\u30fc\u3092\u898b\u305f\">\u99c5\u30dd\u30b9\u30bf\u30fc\u3092\u898b\u305f<\/option><option value=\"yahoo! \u3084Google\u3067\u691c\u7d22\u3057\u3066\u898b\u3064\u3051\u305f\">yahoo! \u3084Google\u3067\u691c\u7d22\u3057\u3066\u898b\u3064\u3051\u305f<\/option><option value=\"\u305d\u306e\u4ed6\u306e\u691c\u7d22\u30b5\u30a4\u30c8\u3067\u691c\u7d22\u3057\u3066\u898b\u3064\u3051\u305f\">\u305d\u306e\u4ed6\u306e\u691c\u7d22\u30b5\u30a4\u30c8\u3067\u691c\u7d22\u3057\u3066\u898b\u3064\u3051\u305f<\/option><option value=\"\u4ed6\u30db\u30fc\u30e0\u30da\u30fc\u30b8\u304b\u3089\u306e\u30ea\u30f3\u30af\u3067\u898b\u3064\u3051\u305f\">\u4ed6\u30db\u30fc\u30e0\u30da\u30fc\u30b8\u304b\u3089\u306e\u30ea\u30f3\u30af\u3067\u898b\u3064\u3051\u305f<\/option><option value=\"\u305d\u306e\u4ed6\">\u305d\u306e\u4ed6<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<th class=\"bold\">\n\t\t\t<p>\u304a\u554f\u3044\u5408\u308f\u305b\u5185\u5bb9\n\t\t\t<\/p>\n\t\t<\/th>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-message\"><textarea cols=\"40\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"your-message\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<th class=\"bold\">\n\t\t\t<p>\u9001\u4fe1\n\t\t\t<\/p>\n\t\t<\/th>\n\t\t<td>\n\t\t\t<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner form_sub_class\" type=\"submit\" value=\"\u9001\u4fe1\u3059\u308b\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n<\/table>\n<p><script>\ndocument.addEventListener( 'wpcf7mailsent', function( event ) {\nlocation = 'https:\/\/www.kusemi.ac.jp\/clark-kurume\/thanks.html';\n}, false );\n<\/script>\n<\/p><p style=\"display: none !important;\" class=\"akismet-fields-container\" data-prefix=\"_wpcf7_ak_\"><label>&#916;<textarea name=\"_wpcf7_ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"_wpcf7_ak_js\" value=\"85\"\/><script>document.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );<\/script><\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n<ul id='related' class='indexStyle clearfix'>\n<li><a href='https:\/\/www.kusemi.ac.jp\/clark-kurume\/inquiry.html'>\n<p class=\"related_title\">\u304a\u554f\u3044\u5408\u308f\u305b<\/p>\n<p class=\"related_text\">\u3054\u76f8\u8ac7\u3084\u3054\u8cea\u554f\u304c\u3054\u3056\u3044\u307e\u3057\u305f\u3089\u3001\u304a\u554f\u3044\u5408\u308f\u305b\u30d5\u30a9\u30fc\u30e0\u304b\u3089\u304a\u6c17\u8efd\u306b\u3054\u9023\u7d61\u304f\u3060\u3055\u3044\u3002<\/p>\n<p><\/a><\/li>\n<li><a href='https:\/\/www.kusemi.ac.jp\/clark-kurume\/qa.html'>\n<p class=\"related_title\">\u3088\u304f\u3042\u308b\u3054\u8cea\u554f<\/p>\n<p 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