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サークル申込みフォーム － 東方紅楼夢9.5 遠野物語／夢の世紀 魅知の旅

ホーム > 1.サークル参加案内 → 2.申込みフォーム → 3.申込み情報の送信 → 4.サークルカット提出 → 5.申込み完了

申込イベント

※JavaScriptとCookieを有効にしてご利用ください。
※の付いた欄は必須記入項目です。

※ 申込みイベント Warning: Use of undefined constant event - assumed 'event' (this will throw an Error in a future version of PHP) in /home/tkmghr/www/cafe-terrace/tono_form/circle_1.php on line 36
checked="checked"> 東方紅楼夢9.5 遠野物語　　 Warning: Use of undefined constant event - assumed 'event' (this will throw an Error in a future version of PHP) in /home/tkmghr/www/cafe-terrace/tono_form/circle_1.php on line 36
> 夢の世紀 魅知の旅

申込代表者情報

※ 氏名▼氏名

▼フリガナ

※長音記号（ー）以外の読みのない記号（・や。など）は省略。
※ 性別 Warning: Use of undefined constant sex - assumed 'sex' (this will throw an Error in a future version of PHP) in /home/tkmghr/www/cafe-terrace/tono_form/circle_1.php on line 43
checked="checked"> 男性　　 Warning: Use of undefined constant sex - assumed 'sex' (this will throw an Error in a future version of PHP) in /home/tkmghr/www/cafe-terrace/tono_form/circle_1.php on line 43
> 女性
※ 生年月日西暦 年　月　日　※半角数字で記入
※ 住所〒 　※例：000-0000
県名から番地まで　※例：××県○○市☆☆町X-X-XX

マンション名、部屋番号など（あれば）
※ 電話番号　※例：000-0000-0000
※ 連絡可能時間　※例：20時～24時
※ E-mail　※半角英数字

申込内容

※ 申込スペース Warning: Use of undefined constant sp - assumed 'sp' (this will throw an Error in a future version of PHP) in /home/tkmghr/www/cafe-terrace/tono_form/circle_1.php on line 53

Warning: Use of undefined constant sp - assumed 'sp' (this will throw an Error in a future version of PHP) in /home/tkmghr/www/cafe-terrace/tono_form/circle_1.php on line 53
checked="checked"> 1sp（3000円） Warning: Use of undefined constant sp - assumed 'sp' (this will throw an Error in a future version of PHP) in /home/tkmghr/www/cafe-terrace/tono_form/circle_1.php on line 53
> 2sp（6000円）
※ 追加イス Warning: Use of undefined constant isu - assumed 'isu' (this will throw an Error in a future version of PHP) in /home/tkmghr/www/cafe-terrace/tono_form/circle_1.php on line 54

Warning: Use of undefined constant isu - assumed 'isu' (this will throw an Error in a future version of PHP) in /home/tkmghr/www/cafe-terrace/tono_form/circle_1.php on line 54
checked="checked"> 不要　　 Warning: Use of undefined constant isu - assumed 'isu' (this will throw an Error in a future version of PHP) in /home/tkmghr/www/cafe-terrace/tono_form/circle_1.php on line 54
> 1脚（500円）　 Warning: Use of undefined constant isu - assumed 'isu' (this will throw an Error in a future version of PHP) in /home/tkmghr/www/cafe-terrace/tono_form/circle_1.php on line 54
> 2脚（1000円）
※ 参加費計　※自動で計算されます
※ 入金方法 Warning: Use of undefined constant credit - assumed 'credit' (this will throw an Error in a future version of PHP) in /home/tkmghr/www/cafe-terrace/tono_form/circle_1.php on line 56
checked="checked"> 銀行振込／振替　　 Warning: Use of undefined constant credit - assumed 'credit' (this will throw an Error in a future version of PHP) in /home/tkmghr/www/cafe-terrace/tono_form/circle_1.php on line 56
> 為替証書を郵送
▼入金日または入金予定日
　※例：5/1

※追加イスの申請は1spにつき1つまでです（1sp申請時は2脚を選択しないでください）

サークル情報

※ サークル名▼サークル名

▼フリガナ

※カナのみのサークルも記入
※長音記号（ー）以外の読みのない記号（・や。など）は省略。
※ ペンネーム▼ペンネーム

※本名と同じ方は本名を記入
▼フリガナ

※カナのみの方も記入
※長音記号（ー）以外の読みのない記号（・や。など）は省略。
Webサイト
Warning: Use of undefined constant website_pub - assumed 'website_pub' (this will throw an Error in a future version of PHP) in /home/tkmghr/www/cafe-terrace/tono_form/circle_1.php on line 68
checked="checked"> サークルリストに公開しても良い　　 Warning: Use of undefined constant website_pub - assumed 'website_pub' (this will throw an Error in a future version of PHP) in /home/tkmghr/www/cafe-terrace/tono_form/circle_1.php on line 68
> 公開を希望しない
Pixiv登録IDhttp://www.pixiv.net/member.php?id=
Warning: Use of undefined constant pixib__pub - assumed 'pixib__pub' (this will throw an Error in a future version of PHP) in /home/tkmghr/www/cafe-terrace/tono_form/circle_1.php on line 69
checked="checked"> サークルリストに公開しても良い　　 Warning: Use of undefined constant pixiv_pub - assumed 'pixiv_pub' (this will throw an Error in a future version of PHP) in /home/tkmghr/www/cafe-terrace/tono_form/circle_1.php on line 69
> 公開を希望しない
pixiv登録IDはプロフィールページの上部に表示されています。
TINAMI登録IDhttp://www.tinami.com/profile/
Warning: Use of undefined constant tinami_pub - assumed 'tinami_pub' (this will throw an Error in a future version of PHP) in /home/tkmghr/www/cafe-terrace/tono_form/circle_1.php on line 70
checked="checked"> サークルリストに公開しても良い　　 Warning: Use of undefined constant tinami_pub - assumed 'tinami_pub' (this will throw an Error in a future version of PHP) in /home/tkmghr/www/cafe-terrace/tono_form/circle_1.php on line 70
> 公開を希望しない
Twitter登録ID@
Warning: Use of undefined constant twitter_pub - assumed 'twitter_pub' (this will throw an Error in a future version of PHP) in /home/tkmghr/www/cafe-terrace/tono_form/circle_1.php on line 71
checked="checked"> サークルリストに公開しても良い　　 Warning: Use of undefined constant twitter_pub - assumed 'twitter_pub' (this will throw an Error in a future version of PHP) in /home/tkmghr/www/cafe-terrace/tono_form/circle_1.php on line 71
> 公開を希望しない
合体希望サークル　※相互に記入時のみ有効

頒布物情報

※現在の予定で結構です。サークル配置の参考にいたします。

※ 頒布物の傾向 Warning: Use of undefined constant genre - assumed 'genre' (this will throw an Error in a future version of PHP) in /home/tkmghr/www/cafe-terrace/tono_form/circle_1.php on line 80

Warning: Use of undefined constant genre - assumed 'genre' (this will throw an Error in a future version of PHP) in /home/tkmghr/www/cafe-terrace/tono_form/circle_1.php on line 80
checked="checked"> 漫画・イラスト
Warning: Use of undefined constant genre - assumed 'genre' (this will throw an Error in a future version of PHP) in /home/tkmghr/www/cafe-terrace/tono_form/circle_1.php on line 81
> 小説・随筆
Warning: Use of undefined constant genre - assumed 'genre' (this will throw an Error in a future version of PHP) in /home/tkmghr/www/cafe-terrace/tono_form/circle_1.php on line 82
> 音楽
Warning: Use of undefined constant genre - assumed 'genre' (this will throw an Error in a future version of PHP) in /home/tkmghr/www/cafe-terrace/tono_form/circle_1.php on line 83
> 映像・動画・ソフトウェア
Warning: Use of undefined constant genre - assumed 'genre' (this will throw an Error in a future version of PHP) in /home/tkmghr/www/cafe-terrace/tono_form/circle_1.php on line 84
> グッズ・無電源ゲーム
Warning: Use of undefined constant genre - assumed 'genre' (this will throw an Error in a future version of PHP) in /home/tkmghr/www/cafe-terrace/tono_form/circle_1.php on line 85
> その他
※複数ある場合はメインとなる作品の傾向を指定
※ 成年向け頒布物 Warning: Use of undefined constant ganre_seijin - assumed 'ganre_seijin' (this will throw an Error in a future version of PHP) in /home/tkmghr/www/cafe-terrace/tono_form/circle_1.php on line 86

Warning: Use of undefined constant ganre_seijin - assumed 'ganre_seijin' (this will throw an Error in a future version of PHP) in /home/tkmghr/www/cafe-terrace/tono_form/circle_1.php on line 86
checked="checked"> なし（隣接しても良い）　 Warning: Use of undefined constant ganre_seijin - assumed 'ganre_seijin' (this will throw an Error in a future version of PHP) in /home/tkmghr/www/cafe-terrace/tono_form/circle_1.php on line 86
> なし（別配置を希望）　 Warning: Use of undefined constant ganre_seijin - assumed 'ganre_seijin' (this will throw an Error in a future version of PHP) in /home/tkmghr/www/cafe-terrace/tono_form/circle_1.php on line 86
> あり
※合体申請される場合は合体先と指定を揃えてください
※ 頒布物詳細 ▼頒布する作品の内容

※決まっていない場合は傾向（シリアス、ほのぼの、ギャグ等）を書いてください
▼持ち込み予定量（頒布物がある場合のみ記入。現時点での予定で結構です）

備考・補足
※申込内容の補足や、配置上の配慮を必要とされる場合はこちらにご記入ください。
※振込の名義が申込者と異なる場合は必ずこちらにその旨を記入してください。

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