<p>*聯絡人：[text* business-name] </p>

<p>性別：[radio business-sex "男" "女"]</p>

<p>*主題分類：[radio business-type1 "食" "衣" "住" "行" "育" "樂"]</p>

<p>*商家分類：[radio business-type2 "在地美食(清水、沙鹿、梧棲)" "在地住宿(清水、沙鹿、梧棲)" "台中美食(不分區)" "台中住宿(不分區)" "觀光景點" "其他外縣市"]</p>

<p>*商家名稱：[text* business-company]</p>

<p>商家簡介：[textarea business-intro]</p>

<p>*營業時間：[text* business-time]</p>

<p>*聯絡電話：[text* business-tel]</p>

<p>*商家地址：[text* business-address]</p>

<p>電子郵件：[text business-email]</p>

<p>商家網站：[text business-web]</p>

<p>商家粉絲團：[text business-facebook]</p>

<p>相片上傳說明：<br />
1.相片尺寸限 1024x768 以內<br />
2.相片類型限 jpg、gif、png 格式<br />
3.檔案大小限 2MB 以內<br />
4.相片版權應為上傳者自行負責，本網站均不負責其版權規屬問題</p>

<p>商家相片1：[file business-photo1]</p>

<p>商家相片2：[file business-photo2]</p>

<p>商家相片3：[file business-photo3]</p>

<p class="tdbun">[submit "確定送出"]</p>