<form id="formExtNewslettersAPAC" accept-charset="UTF-8" action="https://m.info.wiley.com/webApp/formExtNewslettersAPAC" method="post"> <div class="form-group"> <label for="salutation">敬称*</label> <select id="salutation" name="salutation" class="custom-select" required="required"> <option value="">選択ください...</option> <option value="Miss">Miss</option> <option value="Mr.">Mr.</option> <option value="Mrs.">Mrs.</option> <option value="Ms.">Ms.</option> <option value="Mx.">Mx.</option> <option value="Dr.">Dr.</option> <option value="Prof.">Prof.</option> </select> </div> <div class="form-group"> <label for="firstName">名*</label> <input id="firstName" name="firstName" type="text" class="form-control" required="required"> </div> <div class="form-group"> <label for="lastName">姓*</label> <input id="lastName" name="lastName" type="text" class="form-control" required="required"> </div> <div class="form-group"> <label for="email">E-mail*</label> <input id="email" name="email" type="email" required="required" class="form-control"> </div> <div class="form-group"> <label for="companyName">ご所属機関名/社名*</label> <input id="companyName" name="companyName" type="text" class="form-control" required="required"> </div> <div class="form-group"> <label for="title">役職名*</label> <input id="title" name="title" type="text" class="form-control" required="required"> </div> <div class="form-group"> <label for="jobRole">職位*</label> <div> <select id="jobRole" name="jobRole" class="custom-select" required="required"> <option value="">選択ください...</option> <option value="(Librarians) Collection Development/Acquisitions Librarian">Collection Development/Acquisitions Librarian</option> <option value="(Librarians) E-Resources Librarian">E-Resources Librarian</option> <option value="(Librarians) Faculty">Faculty</option> <option value="(Librarians) Library Assistant">Library Assistant</option> <option value="(Librarians) Library Director">Library Director</option> <option value="(Librarians) Library Technician">Library Technician</option> <option value="(Librarians) Reference Librarian">Reference Librarian</option> <option value="(Librarians) Researcher">Researcher</option> <option value="(Librarians) Student">Student</option> <option value="(Librarians) Subject Librarian">Subject Librarian</option> <option value="(Librarians) University Librarian">University Librarian</option> <option value="(Librarians) Other">Other</option> </select> </div> </div> <div class="form-group"> <label for="country">国*</label> <div> <select id="country" name="country" class="custom-select" required="required"> <option value="">Please select...</option>
<option value="AF">Afghanistan</option>
<option value="AX">Aland Islands</option>
<option value="AL">Albania</option>
<option value="DZ">Algeria</option>
<option value="AS">American Samoa</option>
<option value="AD">Andorra</option>
<option value="AO">Angola</option>
<option value="AI">Anguilla</option>
<option value="AQ">Antartica</option>
<option value="AG">Antigua and Barbuda</option>
<option value="AR">Argentina</option>
<option value="AM">Armenia</option>
<option value="AW">Aruba</option>
<option value="AU">Australia</option>
<option value="AT">Austria</option>
<option value="AZ">Azerbaijan</option>
<option value="BS">Bahamas</option>
<option value="BH">Bahrain</option>
<option value="BD">Bangladesh</option>
<option value="BB">Barbados</option>
<option value="BY">Belarus</option>
<option value="BE">Belgium</option>
<option value="BZ">Belize</option>
<option value="BJ">Benin</option>
<option value="BM">Bermuda</option>
<option value="BT">Bhutan</option>
<option value="GW">Bissau</option>
<option value="BO">Bolivia</option>
<option value="BA">Bosnia and Herzegovina</option>
<option value="BW">Botswana</option>
<option value="BV">Bouvet island</option>
<option value="BR">Brazil</option>
<option value="IO">British Indian Ocean Territory</option>
<option value="VG">British Virgin Islands</option>
<option value="BN">Brunei Darussalam</option>
<option value="BG">Bulgaria</option>
<option value="BF">Burkina Faso</option>
<option value="BI">Burundi</option>
<option value="KH">Cambodia</option>
<option value="CM">Cameroon</option>
<option value="CA">Canada</option>
<option value="CV">Cape Verde</option>
<option value="KY">Cayman islands</option>
<option value="CF">Central Africa Republic</option>
<option value="TD">Chad</option>
<option value="CL">Chile</option>
<option value="CN">China</option>
<option value="CX">Christmas Island</option>
<option value="CC">Coco Islands</option>
<option value="CO">Colombia</option>
<option value="KM">Comoros</option>
<option value="CK">Cook Islands</option>
<option value="CR">Costa Rica</option>
<option value="HR">Croatia</option>
<option value="CU">Cuba</option>
<option value="CY">Cyprus</option>
<option value="CZ">Czech Republic</option>
<option value="CD">Democratic Republic of Congo</option>
<option value="DK">Denmark</option>
<option value="DJ">Djibouti</option>
<option value="DM">Dominica</option>
<option value="DO">Dominican Republic</option>
<option value="EC">Ecuador</option>
<option value="EG">Egypt</option>
<option value="SV">El Salvador</option>
<option value="GQ">Equatorial Guinea</option>
<option value="ER">Eritrea</option>
<option value="EE">Estonia</option>
<option value="ET">Ethiopia</option>
<option value="FO">Faeroe Islands</option>
<option value="FK">Falkland Islands</option>
<option value="FJ">Fiji</option>
<option value="FI">Finland</option>
<option value="FR">France</option>
<option value="GF">French Guiana</option>
<option value="PF">French Polynesia</option>
<option value="TF">French Southern Territories</option>
<option value="GA">Gabon</option>
<option value="GM">Gambia</option>
<option value="GE">Georgia</option>
<option value="DE">Germany</option>
<option value="GH">Ghana</option>
<option value="GI">Gibraltar</option>
<option value="GR">Greece</option>
<option value="GL">Greenland</option>
<option value="GD">Grenada</option>
<option value="GP">Guadeloupe</option>
<option value="GU">Guam</option>
<option value="GT">Guatemala</option>
<option value="GN">Guinea</option>
<option value="GY">Guyana</option>
<option value="HT">Haiti</option>
<option value="HM">Heard Island and McDonald Islands</option>
<option value="HN">Honduras</option>
<option value="HK">Hong Kong (SAR China)</option>
<option value="HU">Hungary</option>
<option value="IS">Iceland</option>
<option value="IN">India</option>
<option value="ID">Indonesia</option>
<option value="IR">Iran</option>
<option value="IQ">Iraq</option>
<option value="IE">Ireland</option>
<option value="IL">Israel</option>
<option value="IT">Italy</option>
<option value="CI">Ivory Coast</option>
<option value="JM">Jamaica</option>
<option value="JP">Japan</option>
<option value="JO">Jordan</option>
<option value="KZ">Kazakhstan</option>
<option value="KE">Kenya</option>
<option value="KI">Kiribati</option>
<option value="KR">Korea</option>
<option value="KW">Kuwait</option>
<option value="KG">Kyrgyzstan</option>
<option value="LA">Lao</option>
<option value="LV">Latvia</option>
<option value="LB">Lebanon</option>
<option value="LS">Lesotho</option>
<option value="LR">Liberia</option>
<option value="LY">Libya</option>
<option value="LI">Liechtenstein</option>
<option value="LT">Lithuania</option>
<option value="LU">Luxembourg</option>
<option value="MO">Macau (SAR China)</option>
<option value="MK">Macedonia</option>
<option value="MG">Madagascar</option>
<option value="MW">Malawi</option>
<option value="MY">Malaysia</option>
<option value="MV">Maldives</option>
<option value="ML">Mali</option>
<option value="MT">Malta</option>
<option value="MH">Marshall Islands</option>
<option value="MQ">Martinique</option>
<option value="MR">Mauritania</option>
<option value="MU">Mauritius</option>
<option value="YT">Mayotte</option>
<option value="MX">Mexico</option>
<option value="FM">Micronesia</option>
<option value="MD">Moldova</option>
<option value="MC">Monaco</option>
<option value="MN">Mongolia</option>
<option value="ME">Montenegro</option>
<option value="MS">Montserrat</option>
<option value="MA">Morocco</option>
<option value="MZ">Mozambique</option>
<option value="MM">Myanmar</option>
<option value="NA">Namibia</option>
<option value="NR">Nauru</option>
<option value="NP">Nepal</option>
<option value="NL">Netherlands</option>
<option value="AN">Netherlands Antilles</option>
<option value="NC">New Caledonia</option>
<option value="NZ">New Zealand</option>
<option value="NI">Nicaragua</option>
<option value="NE">Niger</option>
<option value="NG">Nigeria</option>
<option value="NU">Niue</option>
<option value="NF">Norfolk Island</option>
<option value="KP">Northern Korea</option>
<option value="MP">Northern Mariana Islands</option>
<option value="NO">Norway</option>
<option value="OM">Oman</option>
<option value="PK">Pakistan</option>
<option value="PW">Palau</option>
<option value="PS">Palestinian territories</option>
<option value="PA">Panama</option>
<option value="PG">Papua New Guinea</option>
<option value="PY">Paraguay</option>
<option value="PE">Peru</option>
<option value="PH">Philippines</option>
<option value="PN">Pitcairn</option>
<option value="PL">Poland</option>
<option value="PT">Portugal</option>
<option value="PR">Puerto Rico</option>
<option value="QA">Qatar</option>
<option value="CG">Republic of Congo</option>
<option value="RO">Romania</option>
<option value="RU">Russia</option>
<option value="RW">Rwanda</option>
<option value="RE">Réunion</option>
<option value="KN">Saint Kitts and Nevis</option>
<option value="LC">Saint Lucia</option>
<option value="PM">Saint Pierre and Miquelon</option>
<option value="VC">Saint Vincent and the Grenadines</option>
<option value="SH">Saint elena</option>
<option value="WS">Samoa</option>
<option value="SM">San Marino</option>
<option value="ST">Sao Tome and Principe</option>
<option value="SA">Saudi Arabia</option>
<option value="SN">Senegal</option>
<option value="RS">Serbia</option>
<option value="SC">Seychelles</option>
<option value="SL">Sierra Leone</option>
<option value="SG">Singapore</option>
<option value="SK">Slovakia</option>
<option value="SI">Slovenia</option>
<option value="SB">Solomon Islands</option>
<option value="SO">Somalia</option>
<option value="ZA">South Africa</option>
<option value="GS">South Georgia and the South Sandwich Islands</option>
<option value="ES">Spain</option>
<option value="LK">Sri Lanka</option>
<option value="SD">Sudan</option>
<option value="SR">Suriname</option>
<option value="SJ">Svalbard and Jan Mayen</option>
<option value="SZ">Swaziland</option>
<option value="SE">Sweden</option>
<option value="CH">Switzerland</option>
<option value="SY">Syria</option>
<option value="TW">Taiwan</option>
<option value="TJ">Tajikistan</option>
<option value="TZ">Tanzania</option>
<option value="TH">Thailand</option>
<option value="TL">Timor-Leste</option>
<option value="TG">Togo</option>
<option value="TK">Tokelau</option>
<option value="TO">Tonga</option>
<option value="TT">Trinidad and Tobago</option>
<option value="TN">Tunisia</option>
<option value="TR">Turkey</option>
<option value="TM">Turkmenistan</option>
<option value="TC">Turks and Caicos Islands</option>
<option value="TV">Tuvalu</option>
<option value="VI">U.S. Virgin Islands</option>
<option value="UG">Uganda</option>
<option value="UA">Ukraine</option>
<option value="AE">United Arab Emirates</option>
<option value="GB">United Kingdom</option>
<option value="US">United States</option>
<option value="UM">United States Minor Outlying Islands</option>
<option value="UY">Uruguay</option>
<option value="UZ">Uzbekistan</option>
<option value="VU">Vanuatu</option>
<option value="VA">Vatican</option>
<option value="VE">Venezuela</option>
<option value="VN">Vietnam</option>
<option value="WF">Wallis and Futuna</option>
<option value="EH">Western Sahara</option>
<option value="YE">Yemen</option>
<option value="ZM">Zambia</option>
<option value="ZW">Zimbabwe</option>
</select> </div>
</div> <div class="form-group"> <label>どのようなお知らせやプロモーションを受け取りたいですか？</label> <div> <div class="custom-controls-stacked"> <div class="custom-control custom-checkbox"> <input name="productInterest" id="productInterest_0" type="checkbox" class="custom-control-input" value="Wiley Events & Webinars"> <label for="productInterest_0" class="custom-control-label">Wileyのイベントやウェビナーの情報</label> </div> </div> <div class="custom-controls-stacked"> <div class="custom-control custom-checkbox"> <input name="productInterest" id="productInterest_1" type="checkbox" class="custom-control-input" value="Wiley News"> <label for="productInterest_1" class="custom-control-label">Wileyのニュースや最新情報</label> </div> </div> <div class="custom-controls-stacked"> <div class="custom-control custom-checkbox"> <input name="productInterest" id="productInterest_2" type="checkbox" class="custom-control-input" value="Products"> <label for="productInterest_2" class="custom-control-label">製品</label> </div> </div> <div class="custom-controls-stacked"> <div class="custom-control custom-checkbox"> <input name="productInterest" id="productInterest_3" type="checkbox" class="custom-control-input" value="None of the above"> <label for="productInterest_3" class="custom-control-label">上記のどれにも当てはまらない</label> </div> </div> </div> </div> <div class="form-group"> <label>ご興味のある分野・領域にチェックを入れて下さい</label> <div> <div class="custom-controls-stacked"> <div class="custom-control custom-checkbox"> <input name="subjectInterest" id="subjectInterest_0" type="checkbox" class="custom-control-input" value="Earth & Environmental Sciences"> <label for="subjectInterest_0" class="custom-control-label">Earth & Environmental Sciences</label> </div> </div> <div class="custom-controls-stacked"> <div class="custom-control custom-checkbox"> <input name="subjectInterest" id="subjectInterest_1" type="checkbox" class="custom-control-input" value="Life Sciences"> <label for="subjectInterest_1" class="custom-control-label">Life Sciences</label> </div> </div> <div class="custom-controls-stacked"> <div class="custom-control custom-checkbox"> <input name="subjectInterest" id="subjectInterest_2" type="checkbox" class="custom-control-input" value="Medicine"> <label for="subjectInterest_2" class="custom-control-label">Medicine</label> </div> </div> <div class="custom-controls-stacked"> <div class="custom-control custom-checkbox"> <input name="subjectInterest" id="subjectInterest_3" type="checkbox" class="custom-control-input" value="Nursing, Dentistry & Healthcare"> <label for="subjectInterest_3" class="custom-control-label">Nursing, Dentistry & Healthcare</label> </div> </div> <div class="custom-controls-stacked"> <div class="custom-control custom-checkbox"> <input name="subjectInterest" id="subjectInterest_4" type="checkbox" class="custom-control-input" value="Physical Sciences & Engineering"> <label for="subjectInterest_4" class="custom-control-label">Physical Sciences & Engineering</label> </div> </div> <div class="custom-controls-stacked"> <div class="custom-control custom-checkbox"> <input name="subjectInterest" id="subjectInterest_5" type="checkbox" class="custom-control-input" value="Social Sciences & Humanities"> <label for="subjectInterest_5" class="custom-control-label">Social Sciences & Humanities</label> </div> </div> <div class="custom-controls-stacked"> <div class="custom-control custom-checkbox"> <input name="subjectInterest" id="subjectInterest_6" type="checkbox" class="custom-control-input" value="Not applicable"> <label for="subjectInterest_6" class="custom-control-label">該当しない</label> </div> </div> <div class="custom-controls-stacked"> <div class="custom-control custom-checkbox"> <input name="subjectInterest" id="subjectInterest_7" type="checkbox" class="custom-control-input" value="Others"> <label for="subjectInterest_7" class="custom-control-label">その他</label> </div> </div> </div> </div> <div class="form-group"> <label for="subjectInterestOthers">その他の場合、分野・領域を詳しく入力して下さい </label> <input id="subjectInterestOthers" name="subjectInterestOthers" type="text" class="form-control"> </div> <div class="form-group"> <div> <div class="custom-controls-stacked"> <div class="custom-control custom-checkbox"> <input name="privacyPolicy" id="privacyPolicy" type="checkbox" required="required" class="custom-control-input" value="true"> <label for="privacyPolicy" class="custom-control-label">はい、Wileyの <a href="https://www.wiley.com/privacy" target="_blank">プライベートポリシー</a> と、</a><a href="https://www.wiley.com/terms-of-use" target="_blank">利用規約</a>を読んだ上で同意します。</a>*</label> </div> </div> </div> </div> <div class="form-group"> <div> <div class="custom-controls-stacked"> <div class="custom-control custom-checkbox"> <input name="consent" id="consent" type="checkbox" class="custom-control-input" value="true"> <label for="consent" class="custom-control-label">はい、Wileyの製品、サービスやイベント情報などのプロモーションを受け取ることを希望します。</label> </div> </div> </div> </div> <input id="vid" name="vid" type="hidden" value=""> <input type="hidden" name="product" id="" value=""> <input type="hidden" name="interest" id="" value=""> <input id="utm_campaign" name="utm_campaign" type="hidden" value=""> <input id="utm_content" name="utm_content" type="hidden" value=""> <input id="utm_medium" name="utm_medium" type="hidden" value=""> <input id="utm_source" name="utm_source" type="hidden" value=""> <input id="utm_term" name="utm_term" type="hidden" value=""> <div class="form-group"> <button name="submit" type="submit" class="btn btn-primary">送信</button> </div>
</form>
<script src="https://ajax.googleapis.com/ajax/libs/jquery/3.7.0/jquery.min.js"></script> <script> $('input[name="productInterest"]').change(function(){ var subs = $.map($(':checkbox[name=productInterest]:checked'), function(n, i){ return n.value; }).join(','); $('input[name="product"]').val(subs); }); $('input[name="subjectInterest"]').change(function(){ var subs = $.map($(':checkbox[name=subjectInterest]:checked'), function(n, i){ return n.value; }).join(','); $('input[name="interest"]').val(subs); }); </script>