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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"FAXでカンタンお申し込み！",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"FAX　045-472-2777"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null," ユニバーサル・ブロード サービス 新規入会申込書",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"会津若松市",null,null,null,null,null,null,null,null,null,null,null,null,"HU"]
[null,null,null,null,"E","C","会津若松市",null,null,null,null,null,null,null,null,"U-Broad 12M",null,null,null,null,"U-Broad 47M",null,null,null,null,"Reach DSL",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0]
[null,null,null,null,null,"C","いわき三坂局",null,null,null,null,null,null,null,null,"U-Broad 12M",null,null,null,null,"U-Broad 47M",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0]
[null,null,null,null,null,"C","上三坂地区・下三坂地区",null,null,null,null,null,null,null,null,"無線LAN",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0]
[null,null,null,null,null,"C","いわき沢渡局",null,null,null,null,null,null,null,null,"U-Broad 12M",null,null,null,null,"U-Broad 47M",null,null,null,null,"Reach DSL",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0]
[null,null,null,null,null,"C","差塩北地区・差塩南地区",null,null,null,null,null,null,null,null,"無線LAN",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0]
[null,null,null,null,null,"C","合戸局",null,null,null,null,null,null,null,null,"U-Broad 12M",null,null,null,null,"U-Broad 47M",null,null,null,null,"Reach DSL",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0]
[null,null,null,null,null,"C","上永井地区",null,null,null,null,null,null,null,null,"無線LAN",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0]
[null,null,null,null,null,"C","山田小湊局",null,null,null,null,null,null,null,null,"U-Broad 12M",null,null,null,null,"U-Broad 47M",null,null,null,null,"Reach DSL",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0]
[null,null,null,null,null,"C","豊間局",null,null,null,null,null,null,null,null,"U-Broad 12M",null,null,null,null,"U-Broad 47M",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0]
[null,null,null,null,null,"C","川前局",null,null,null,null,null,null,null,null,"U-Broad 12M",null,null,null,null,"U-Broad 47M",null,null,null,null,"Reach DSL",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0]
[null,null,null,null,null,"C","川前地区・小白井地区・宇根尻地区",null,null,null,null,null,null,null,null,"無線LAN",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0]
[null,null,null,null,null,"C","荷路夫局",null,null,null,null,null,null,null,null,"U-Broad 12M",null,null,null,null,"U-Broad 47M",null,null,null,null,"Reach DSL",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0]
[null,null,null,null,null,"C","田人局",null,null,null,null,null,null,null,null,"U-Broad 12M",null,null,null,null,"U-Broad 47M",null,null,null,null,"Reach DSL",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0]
[null,null,null,null,null,"C","内倉局",null,null,null,null,null,null,null,null,"U-Broad 12M",null,null,null,null,"U-Broad 47M",null,null,null,null,"Reach DSL",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0]
[]
["株式会社イージェーワークスの定める「ユニバーサル・ブロードサービス契約約款」、及び「個人情報のお取り扱いについて」に同意の上、下記の通り申し込みます。"]
["「ユニバーサル・ブロードサービス契約約款」、及び各サービスの「利用規約等」は、Webページ（ https://u-broad.jp/agreement/ ）にてご確認ください。"]
[]
["株式会社イージェーワークス　宛",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"< * は必須項目です>",null,null,null,null,null,null,"ご記入年月日",null,null,null,null,null,null,null,null,null,"年",null,null,"月",null,null,"日"]
[]
["ご契約者情報"]
["ご契約者氏名 *",null,null,null,null,null,null,"フリガナ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"性別",null,null,null,null,null,"□","男性",null,null,"□","女性"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"生年月日（西暦）",null,null,null,null,null,null,null,null,null,"年",null,null,"月",null,null,"日"]
["ご契約者住所 *",null,null,null,null,null,null,"フリガナ"]
[null,null,null,null,null,null,null,"〒",null,null,null,null,null,null,null,"都道\n府県",null,null,null,null,null,null,null,"市区\n町村"]
[]
["ご連絡先電話番号 *",null,null,null,null,null,null,"（",null,null,null,null,"）",null,null,null,null,"－",null,null,null,null,null,"FAX番号",null,null,null,null,null,null,"（",null,null,null,null,"）",null,null,null,null,"－"]
["昼間連絡先",null,null,null,null,null,null,"（",null,null,null,null,"）",null,null,null,null,"－",null,null,null,null,null,"※ 平日の昼間にご連絡のできる携帯電話・勤務先等をご記入ください。"]
[]
["ご希望の接続サービス"]
["接続サービス *",null,null,null,null,null,null,{"$f":"IF(I36=\"\",\"\",\"□\")","v":"□"},{"$f":"VLOOKUP($AI$3,提供サービス,10,FALSE)&\"\"","v":"U-Broad 12M"},null,null,null,null,null,null,null,{"$f":"IF(R36=\"\",\"\",\"□\")","v":"□"},{"$f":"VLOOKUP($AI$3,提供サービス,15,FALSE)&\"\"","v":"U-Broad 47M"},null,null,null,null,null,null,null,{"$f":"IF(AA36=\"\",\"\",\"□\")","v":"□"},{"$f":"VLOOKUP($AI$3,提供サービス,20,FALSE)&\"\"","v":"Reach DSL"}]
["ADSLタイプ *",null,null,null,null,null,null,"□","タイプ1",null,null,null,null,"※ 電話共用タイプ：ご利用中の加入電話回線でADSLを使用される場合はこちらを選択してください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(ISERROR(FIND(\"無線LAN\",$I$36)),\"\",0)","v":""}]
[null,null,null,null,null,null,null,"□","タイプ2",null,null,null,null,"※ ADSL専用タイプ：ADSL用に回線を新設される場合はこちらを選択してください。\n※ タイプ2はNTT敷設費用が別途発生いたします。\n※ お申し込みには「同一建物内の回線電話番号とその名義人」情報または「身分証明書コピー」が必要となります。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(ISERROR(FIND(\"無線LAN\",$I$36)),\"\",0)","v":""}]
[]
["設置先回線情報 "]
[{"$f":"IF(I36=\"無線LAN\",\"無線LAN設置先住所\",\"ADSL設置先住所\")","v":"ADSL設置先住所"},null,null,null,null,null,"*","□","ご契約者住所と同じ",null,null,null,null,null,null,null,"□","その他の住所（下記をご記入ください）"]
[null,null,null,null,null,null,null,"フリガナ"]
[null,null,null,null,null,null,null,"〒",null,null,null,null,null,null,null,"都道\n府県",null,null,null,null,null,null,null,"市区\n町村"]
[]
[{"$f":"IF(I36=\"無線LAN\",\"設置先電話番号\",\"ADSL利用電話番号\")","v":"ADSL利用電話番号"},null,null,null,null,null,"*","□","ご連絡先電話番号と同じ",null,null,null,null,null,null,null,"□","その他の電話番号（下記をご記入ください）",null,null,null,null,null,null,null,null,null,null,null,"□","なし（アナログ回線を新設しタイプ2を申し込む）"]
[null,null,null,null,null,null,null,"（",null,null,null,null,"）",null,null,null,null,"－",null,null,null,null,null,{"$f":"IF(I36=\"無線LAN\",\"※ 無線LANを利用する電話番号または、ご利用場所に設置されている電話番号をご記入ください。\",\"※ ADSLを利用する電話番号または、ご利用場所に設置されている電話番号をご記入ください。\")","v":"※ ADSLを利用する電話番号または、ご利用場所に設置されている電話番号をご記入ください。"}]
["電話回線名義 *",null,null,null,null,null,null,"フリガナ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※ NTT東日本へご登録のご契約者名（回線名義）を正確にご記入ください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(ISERROR(FIND(\"無線LAN\",$I$36)),\"\",0)","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,""]
["現在の回線種類\n* タイプ1をお申込みの場合は必ずご記入ください。",null,null,null,null,null,null,"□","アナログ回線",null,null,null,null,null,"□"," INSネット64（ISDN）　　※ 現在利用しているISDN回線をアナログ回線へ変更が必要です。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,"<<< 【重要】 現在ご利用の回線タイプがINSネット64のお客様はアナログに変更のお手続きを行ってください >>>",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,"お客様にてNTT116へお電話いただき、「ADSLを利用するためアナログ回線へ変更を希望」と伝え、「工事日は本お申込み予定日から１５日以降」でご依頼ください。また、(1)アナログ回線への切替工事指定日と、(2)NTT116担当者氏名を必ずご記入ください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,"アナログへの切替工事日",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年",null,null,"月",null,null,"日",null,"※ サービスの開通調整に必要な為必ずご記入ください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,"NTT116担当者氏名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※ NTT東日本との調整が必要な為必ずご確認ください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,""]
[]
["お支払い情報"]
["お支払い方法 *",null,null,null,null,null,null,"□","クレジットカード払い",null,null,null,null,null,null,"※ お申込み情報登録後、ご希望のお支払い方法に応じた記入用紙を郵送いたします。\n※ お支払い方法が選択されていない場合は、コンビニ請求書でのお支払いとさせていただきます。\n※ 口座振替の場合は、別途、口座振替決済管理費139円（税抜）/月がかかります。"]
[null,null,null,null,null,null,null,"□","口座振替"]
[null,null,null,null,null,null,null,"□","コンビニ決済払い"]
[]
["ご希望の基本メールアドレス"]
["* 弊社からメンテナンスのお知らせ等を送信しますので必ずご記入ください。\n※ 3文字以上16字以内、英小文字数字 （ a-z 、 0-9 ） 、 記号 （ ハイフン[ - ] 、 アンダーバー [ _ ] 、 ドット [ . ] ） でご記入ください。\n※ 先頭文字は英小文字でご記入ください。\n※ 記号を連続して使用することはできません。また、記号をアットマーク [ @ ] の直前に使用することはできません。"]
["第1希望",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"@u-broad.jp"]
["第2希望",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"@u-broad.jp"]
["第3希望",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"@u-broad.jp"]
[]
["ご不明な点等ございましたら下記お問合せ窓口までお問合せ下さい"]
["郵送先",null,null,null,"〒222-0033　横浜市港北区新横浜3-1-9　13F",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"お電話でのお問い合わせ"]
[null,null,null,null,"株式会社イージェーワークス\nU-Broad カスタマーサポート宛",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"0120-511-155\n10:00～19:00 （土日祝休）\n携帯電話・PHSからもご利用できます"]
["FAX",null,null,null,"０４５-４７２-２７７７"]
[]
["代理店記入欄",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"キャンペーンコード"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"代理店コード"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"SUBSTITUTE(REPLACE(LEFT(CELL(\"filename\",$A$1),FIND(\".xl\",CELL(\"filename\",$A$1))-1),1,FIND(\"[\",CELL(\"filename\",$A$1)),),\"【U-Broad】\",\"ユニバーサル・ブロードサービス \")","v":"ユニバーサル・ブロードサービス 新規入会申込書（東日本エリア版）Prev1.4"}]

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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"FAXでカンタンお申し込み！",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"FAX　045-472-2777"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null," ユニバーサル・ブロード サービス 新規申込書",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"'【U-Broad】新規申込書（東日本エリア版）'!AI3:AT3","v":"会津若松市"},null,null,null,null,null,null,null,null,null,null,null,null,"HU"]
[null,null,null,null,"E","C","会津若松市",null,null,null,null,null,null,null,null,"U-Broad 12M",null,null,null,null,"U-Broad 47M",null,null,null,null,"Reach DSL",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0]
[null,null,null,null,null,"C","いわき三坂局",null,null,null,null,null,null,null,null,"U-Broad 12M",null,null,null,null,"U-Broad 47M",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0]
[null,null,null,null,null,"C","上三坂地区・下三坂地区",null,null,null,null,null,null,null,null,"無線LAN",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0]
[null,null,null,null,null,"C","いわき沢渡局",null,null,null,null,null,null,null,null,"U-Broad 12M",null,null,null,null,"U-Broad 47M",null,null,null,null,"Reach DSL",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0]
[null,null,null,null,null,"C","差塩北地区・差塩南地区",null,null,null,null,null,null,null,null,"無線LAN",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0]
[null,null,null,null,null,"C","合戸局",null,null,null,null,null,null,null,null,"U-Broad 12M",null,null,null,null,"U-Broad 47M",null,null,null,null,"Reach DSL",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0]
[null,null,null,null,null,"C","上永井地区",null,null,null,null,null,null,null,null,"無線LAN",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0]
[null,null,null,null,null,"C","山田小湊局",null,null,null,null,null,null,null,null,"U-Broad 12M",null,null,null,null,"U-Broad 47M",null,null,null,null,"Reach DSL",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0]
[null,null,null,null,null,"C","豊間局",null,null,null,null,null,null,null,null,"U-Broad 12M",null,null,null,null,"U-Broad 47M",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0]
[null,null,null,null,null,"C","川前局",null,null,null,null,null,null,null,null,"U-Broad 12M",null,null,null,null,"U-Broad 47M",null,null,null,null,"Reach DSL",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0]
[null,null,null,null,null,"C","川前地区・小白井地区・宇根尻地区",null,null,null,null,null,null,null,null,"無線LAN",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0]
[null,null,null,null,null,"C","荷路夫局",null,null,null,null,null,null,null,null,"U-Broad 12M",null,null,null,null,"U-Broad 47M",null,null,null,null,"Reach DSL",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0]
[null,null,null,null,null,"C","田人局",null,null,null,null,null,null,null,null,"U-Broad 12M",null,null,null,null,"U-Broad 47M",null,null,null,null,"Reach DSL",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0]
[null,null,null,null,null,"C","内倉局",null,null,null,null,null,null,null,null,"U-Broad 12M",null,null,null,null,"U-Broad 47M",null,null,null,null,"Reach DSL",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0]
[]
["株式会社イージェーワークスの定める「ユニバーサル・ブロードサービス契約約款」、及び「個人情報のお取り扱いについて」に同意の上、下記の通り申し込みます。"]
["「ユニバーサル・ブロードサービス契約約款」、及び各サービスの「利用規約等」は、Webページ（ https://u-broad.jp/agreement/ ）にてご確認ください。"]
[]
["株式会社イージェーワークス　宛",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"< * は必須項目です>",null,null,null,null,null,null,"ご記入年月日",null,null,null,null,null,"〇",null,null,null,"年","〇",null,"月","〇",null,"日"]
[]
["ご契約者情報"]
["ご契約者氏名 *",null,null,null,null,null,null,"フリガナ",null,null,"シンヨコ　タロウ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"性別",null,null,null,null,null,"□","男性",null,null,"□","女性"]
[null,null,null,null,null,null,null,"新横　太郎",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"生年月日（西暦）",null,null,null,null,null,"〇",null,null,null,"年","〇",null,"月","〇",null,"日"]
["ご契約者住所 *",null,null,null,null,null,null,"フリガナ",null,null,"カナガワケンヨコハマシコウホククシンヨコハマ"]
[null,null,null,null,null,null,null,"〒","222-0033",null,null,"神奈川",null,null,null,"都道\n府県",null,"横浜",null,null,null,null,null,"市区\n町村",null,"港北区新横浜3-1-9 13F"]
[]
["ご連絡先電話番号 *",null,null,null,null,null,null,"（","000",null,null,null,"）","000",null,null,null,"－","0000",null,null,null,null,"FAX番号",null,null,null,null,null,null,"（","000",null,null,null,"）","000",null,null,null,"－","0000"]
["昼間連絡先",null,null,null,null,null,null,"（","000",null,null,null,"）","000",null,null,null,"－","0000",null,null,null,null,"※ 平日の昼間にご連絡のできる携帯電話・勤務先等をご記入ください。"]
[]
["ご希望の接続サービス"]
["接続サービス *",null,null,null,null,null,null,{"$f":"IF(I36=\"\",\"\",\"□\")","v":"□"},{"$f":"VLOOKUP($AI$3,提供サービス,10,FALSE)&\"\"","v":"U-Broad 12M"},null,null,null,null,null,null,null,{"$f":"IF(R36=\"\",\"\",\"□\")","v":"□"},{"$f":"VLOOKUP($AI$3,提供サービス,15,FALSE)&\"\"","v":"U-Broad 47M"},null,null,null,null,null,null,null,{"$f":"IF(AA36=\"\",\"\",\"□\")","v":"□"},{"$f":"VLOOKUP($AI$3,提供サービス,20,FALSE)&\"\"","v":"Reach DSL"}]
["ADSLタイプ *",null,null,null,null,null,null,"□","タイプ1",null,null,null,null,"※ 電話共用タイプ：ご利用中の加入電話回線でADSLを使用される場合はこちらを選択してください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(ISERROR(FIND(\"無線LAN\",$I$36)),\"\",0)","v":""}]
[null,null,null,null,null,null,null,"□","タイプ2",null,null,null,null,"※ ADSL専用タイプ：ADSL用に回線を新設される場合はこちらを選択してください。\n※ タイプ2はNTT敷設費用が別途発生いたします。\n※ お申し込みには「同一建物内の回線電話番号とその名義人」情報または「身分証明書コピー」が必要となります。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(ISERROR(FIND(\"無線LAN\",$I$36)),\"\",0)","v":""}]
[]
["設置先回線情報"]
[{"$f":"IF(I36=\"無線LAN\",\"無線LAN設置先住所\",\"ADSL設置先住所\")","v":"ADSL設置先住所"},null,null,null,null,null,"*","□","ご契約者住所と同じ",null,null,null,null,null,null,null,"□","その他の住所（下記をご記入ください）"]
[null,null,null,null,null,null,null,"フリガナ"]
[null,null,null,null,null,null,null,"〒",null,null,null,null,null,null,null,"都道\n府県",null,null,null,null,null,null,null,"市区\n町村"]
[]
[{"$f":"IF(I36=\"無線LAN\",\"設置先電話番号\",\"ADSL利用電話番号\")","v":"ADSL利用電話番号"},null,null,null,null,null,"*","□","ご連絡先電話番号と同じ",null,null,null,null,null,null,null,"□","その他の電話番号（下記をご記入ください）",null,null,null,null,null,null,null,null,null,null,null,"□","なし（アナログ回線を新設しタイプ2を申し込む）"]
[null,null,null,null,null,null,null,"（","000",null,null,null,"）","000",null,null,null,"－","0001",null,null,null,null,{"$f":"IF(I36=\"無線LAN\",\"※ 無線LANを利用する電話番号または、ご利用場所に設置されている電話番号をご記入ください。\",\"※ ADSLを利用する電話番号または、ご利用場所に設置されている電話番号をご記入ください。\")","v":"※ ADSLを利用する電話番号または、ご利用場所に設置されている電話番号をご記入ください。"}]
["電話回線名義 *",null,null,null,null,null,null,"フリガナ",null,null,"シンヨコ　ジロウ",null,null,null,null,null,null,null,null,null,null,null,null,"※ NTT東日本へご登録のご契約者名（回線名義）を正確にご記入ください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(ISERROR(FIND(\"無線LAN\",$I$36)),\"\",0)","v":""}]
[null,null,null,null,null,null,null,"新横　二郎",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,""]
["現在の回線種類\n* タイプ1をお申込みの場合は必ずご記入ください。",null,null,null,null,null,null,"□","アナログ回線",null,null,null,null,null,"□"," INSネット64（ISDN）　　※ 現在利用しているISDN回線をアナログ回線へ変更が必要です。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,"<<< 【重要】 現在ご利用の回線タイプがINSネット64のお客様はアナログに変更のお手続きを行ってください >>>",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,"お客様にてNTT116へお電話いただき、「ADSLを利用するためアナログ回線へ変更を希望」と伝え、「工事日は本お申込み予定日から１５日以降」でご依頼ください。また、(1)アナログ回線への切替工事指定日と、(2)NTT116担当者氏名を必ずご記入ください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,"アナログへの切替工事日",null,null,null,null,null,null,null,"〇",null,null,null,null,null,null,"年","〇",null,"月","〇",null,"日",null,"※ サービスの開通調整に必要な為必ずご記入ください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,"NTT116担当者氏名",null,null,null,null,null,null,null,"〇〇　〇〇",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※ NTT東日本との調整が必要な為必ずご確認ください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,""]
[]
["お支払い情報"]
["お支払い方法 *",null,null,null,null,null,null,"□","クレジットカード払い",null,null,null,null,null,null,"※ お申込み情報登録後、ご希望のお支払い方法に応じた記入用紙を郵送いたします。\n※ お支払い方法が選択されていない場合は、コンビニ請求書でのお支払いとさせていただきます。"]
[null,null,null,null,null,null,null,"□","口座振替"]
[null,null,null,null,null,null,null,"□","コンビニ決済払い"]
[]
["ご希望の基本メールアドレス"]
["* 弊社からメンテナンスのお知らせ等を送信しますので必ずご記入ください。\n※ 3文字以上16字以内、英小文字数字 （ a-z 、 0-9 ） 、 記号 （ ハイフン[ - ] 、 アンダーバー [ _ ] 、 ドット [ . ] ） でご記入ください。\n※ 先頭文字は英小文字でご記入ください。\n※ 記号を連続して使用することはできません。また、記号をアットマーク [ @ ] の直前に使用することはできません。"]
["第1希望",null,null,null,null,null,null,"t",null,"a",null,"r",null,"o",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"@u-broad.jp"]
["第2希望",null,null,null,null,null,null,"t",null,"a",null,"r",null,"o",null,"-",null,"s",null,"h",null,"i",null,"n",null,"y",null,"o",null,"k",null,"o",null,null,null,null,null,null,null,"@u-broad.jp"]
["第3希望",null,null,null,null,null,null,"t",null,"a",null,"r",null,"o",null,"_",null,"s",null,"h",null,"i",null,"n",null,"y",null,"o",null,"k",null,"o",null,null,null,null,null,null,null,"@u-broad.jp"]
[]
["ご不明な点等ございましたら下記お問合せ窓口までお問合せ下さい"]
["郵送先",null,null,null,"〒222-0033　横浜市港北区新横浜3-1-9　13F",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"お電話でのお問い合わせ"]
[null,null,null,null,"株式会社イージェーワークス\nU-Broad カスタマーサポート宛",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"0120-511-155\n10:00～19:00 （土日祝休）\n携帯電話・PHSからもご利用できます"]
["FAX",null,null,null,"０４５-４７２-２７７７"]
[]
["代理店記入欄",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"キャンペーンコード"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"代理店コード",null,null,null,null,null,null,"UBEJ001"]
[]
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