document.write('<div id="out_table">');
document.write('<form action="//amamin.jp/survey_result.php" method="post"><input type="hidden" name="csrf" value="f974ab708a6a608b6999e5a3527373b0edc10c9d" />');
document.write('<div id="survey_title">');
document.write('奄美とあなたの関係');
document.write('</div>');
document.write('<div id="survey_time">2015/02/06～2015/02/19</div>');
document.write('<div id="survey_brief">しーまを見てくれているあなたは、奄美出身者？それとも奄美ファン？<br />あなたと奄美の関係性を教えてください(^Д^)</div>');
document.write('<table class="survey_vote">');
document.write('<tr class="survey_vote"><td class="survey_vote"></td><td class="survey_vote"><label for="0">奄美出身（出生、または幼少期を過ごした）</label></td></tr><tr class="survey_vote"><td class="survey_vote"></td><td class="survey_vote"><label for="1">奄美二世・三世</label></td></tr><tr class="survey_vote"><td class="survey_vote"></td><td class="survey_vote"><label for="2">住んだことはないが奄美ファン（奄美が気になる）</label></td></tr><tr class="survey_vote"><td class="survey_vote"></td><td class="survey_vote"><label for="3">転勤・結婚等で奄美に住んでいる（住んでいた）</label></td></tr><tr class="survey_vote"><td class="survey_vote"></td><td class="survey_vote"><label for="4">その他</label></td></tr>');
document.write('</table>');
document.write('');
document.write('<div id="vote_button">');
document.write('<p class="bt"></p>');
document.write('<p class="more"><a href="//amamin.jp/survey_result.php?id=65&page=2">投票結果を見る</a></p>');
document.write('</div>');
document.write('<input type="hidden" name="id" value="65">');
document.write('</form>');
document.write('</div>');