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src="../templates/main/js/common_dt.js"></script> <div class="maincontent" style="margin:15px auto;background:#fff;"> <!-- 添加顾客需求 --> <div class="demand_reg mb15" style="height:280px;"> <div class="demand_tit"> <span class="style-red fl ml10">☑</span> <b class="style-red fl fs16 ml10">添加顾客需求</b> <span class="style-gray fr fs14 mr10">添加您的需求并留下您的联系方式，就近优秀直销精英将主动与您取得联系。</span> </div> <div class="reg_con fs14"> <!-- 左侧checkbox --> <div class="reg_l fl"> <img src="../templates/main/images/img1/demand_add.jpg" style="width: 420px; border-radius: 5px;" /> </div> <!-- 中间text资料★ --> <div class="reg_m fl"> <p> 请填写如下信息，带<span class="style-red ml5">*</span>为必填 </p> <p> 您的称呼 : <input type="text" name="txtRealName" id="txtRealName" /> <span class="style-red ml5">*</span> </p> <p> 手机号码 : <input type="text" name="txtMobile" id="txtMobile" /> <span class="style-red ml5">*</span> </p> <p> 所在地区 : <select name="sheng" id="sheng" style="line-height: 30px; height: 30px;"> <option value="9999" selected="selected">所在省份</option> </select> <select name="shi" id="shi" style="line-height: 30px; height: 30px;"> <option value="0">所在城市</option> </select> </p> <p> 关注品牌 : <select name="brand" id="brand" size="1" style="line-height: 30px; height: 30px;"> <option value="0" selected="selected">按品牌</option> <option value="192" selected="">丰貌</option> <option value="28" selected="">玫琳凯</option> <option value="37" selected="">天狮</option> <option value="44" selected="">如新</option> <option value="7" selected="">葆婴</option> <option value="4" selected="">安利</option> <option value="12" selected="">国珍</option> <option value="24" selected="">隆力奇</option> <option value="60" selected="">金木集团</option> <option value="34" selected="">圣原</option> <option value="36" selected="">天美仕</option> <option value="185" selected="">美商凯丽</option> <option value="32" selected="">三生</option> <option value="29" selected="">美罗</option> <option value="39" selected="">无限极</option> <option value="33" selected="">尚赫</option> <option value="42" selected="">中脉</option> <option value="41" selected="">炎帝</option> <option value="31" selected="">荣格</option> <option value="20" selected="">康美</option> <option value="26" selected="">绿之韵</option> <option value="38" selected="">完美</option> <option value="181" selected="">爱健康</option> <option value="180" selected="">Newulife</option> <option value="30" selected="">欧瑞莲</option> <option value="188" selected="">康瞳</option> <option value="138" selected="">哈药</option> <option value="14" selected="">嘉康利</option> <option value="35" selected="">太阳神</option> <option value="21" selected="">康婷</option> <option value="6" selected="">宝健</option> <option value="3" selected="">安惠生物</option> <option value="8" selected="">长青</option> <option value="9" selected="">春芝堂</option> <option value="10" selected="">东升</option> <option value="11" selected="">富迪</option> <option value="23" selected="">理想</option> <option value="25" selected="">罗麦</option> <option value="15" selected="">金日</option> <option value="16" selected="">金士力</option> <option value="17" selected="">九极</option> <option value="18" selected="">康宝莱</option> <option value="19" selected="">康力</option> <option value="5" selected="">安然纳米</option> <option value="27" selected="">美乐家</option> <option value="47" selected="">吉美</option> <option value="48" selected="">湖南华莱</option> <option value="49" selected="">爱睿希</option> <option value="50" selected="">菲丽得</option> <option value="51" selected="">福能源</option> <option value="52" selected="">海济生物</option> <option value="53" selected="">山西恒义</option> <option value="55" selected="">华瑞参业</option> <option value="56" selected="">佳信佰</option> <option value="57" selected="">婕斯</option> <option value="58" selected="">金科伟业</option> <option value="59" selected="">金芦荟</option> <option value="61" selected="">九天绿</option> <option value="62" selected="">康满家</option> <option value="63" selected="">康普</option> <option value="64" selected="">康神科技</option> <option value="65" selected="">克缇</option> <option value="66" selected="">乐利来</option> <option value="67" selected="">绿叶</option> <option value="69" selected="">鹏烨</option> <option value="74" selected="">维迈</option> <option value="75" selected="">铸源</option> <option value="77" selected="">未来生物</option> <option value="79" selected="">永春堂</option> <option value="80" selected="">优莎娜</option> <option value="81" selected="">远东</option> <option value="82" selected="">宝狮龙</option> <option value="83" selected="">三八妇乐</option> <option value="84" selected="">绿力美家</option> <option value="87" selected="">海之巢</option> <option value="88" selected="">和合康源</option> <option value="89" selected="">绿想</option> <option value="90" selected="">美洲矿业</option> <option value="92" selected="">瑞成宇和</option> <option value="93" selected="">顺芝堂</option> <option value="100" selected="">保罗</option> <option value="104" selected="">御淑丹</option> <option value="105" selected="">科创中衡</option> <option value="106" selected="">保姿</option> <option value="107" selected="">宇昌</option> <option value="108" selected="">御淑清丹</option> <option value="109" selected="">康美来</option> <option value="110" selected="">跃莱</option> <option value="112" selected="">慷翠莱</option> <option value="113" selected="">宝丽</option> <option value="117" selected="">宏旺</option> <option value="118" selected="">鑫亚</option> <option value="119" selected="">江南芙蓉王</option> <option value="122" selected="">鲁邦</option> <option value="123" selected="">华芝国际</option> <option value="124" selected="">昇力元</option> <option value="125" selected="">东方药林</option> <option value="126" selected="">山东卫康</option> <option value="128" selected="">博澳克</option> <option value="129" selected="">爱身健丽</option> <option value="130" selected="">福维克</option> <option value="131" selected="">爱邻乐</option> <option value="132" selected="">莱蒂菲</option> <option value="136" selected="">益宝生物</option> <option value="139" selected="">东阿阿胶</option> <option value="140" selected="">东方红</option> <option value="141" selected="">宇航人</option> <option value="142" selected="">荟生</option> <option value="143" selected="">双迪</option> <option value="144" selected="">新科奇</option> <option value="146" selected="">安发</option> <option value="148" selected="">宝恒</option> <option value="149" selected="">鼎鑫沙棘</option> <option value="150" selected="">福瑞达</option> <option value="151" selected="">福莱</option> <option value="152" selected="">恒义</option> <option value="153" selected="">华理</option> <option value="154" selected="">华韬</option> <option value="155" selected="">金岭茶业</option> <option value="157" selected="">佳莱</option> <option value="158" selected="">康尔</option> <option value="159" selected="">康神</option> <option value="161" selected="">康宏</option> <option value="162" selected="">乐活天下</option> <option value="163" selected="">绿世界</option> <option value="164" selected="">莱芙蔻</option> <option value="165" selected="">圃美多</option> <option value="166" selected="">瑞芝</option> <option value="167" selected="">同源双青</option> <option value="172" selected="">北方大陆</option> <option value="173" selected="">康恩贝</option> <option value="191" selected="">仁和</option> <option value="193" selected="">理视康</option> <option value="182" selected="">艾多美</option> <option value="184" selected="">crowd1</option> <option value="186" selected="">优康国际</option> <option value="187" selected="">Viiva</option> </select> <span class="style-red ml5">*</span> <span class="style-red">选择关注品牌</span> </p> </div> <!-- 右侧textarea --> <div class="reg_r fl"> <div> <h4>请登记您的需求内容: <span class="small-sub-title">（ 请将字数控制在150字以内 ）</span> </h4> <p class="row"> <span> <textarea cols="40" rows="8" name="txtcontent" id="txtCont" placeholder="请填写需求内容···"></textarea> </span> </p> <p> <span>验证码 <!--<input id="txtCode" autocomplete="off" style="width:58px;border:1px solid #ccc;height:22px;" /> <img src="/createImg.aspx" onclick="this.src=this.src+'?'" style="cursor: 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